title: Galectin-3 and HBME-1 improve the accuracy of core biopsy in indeterminate thyroid nodules.
abstract: Core needle biopsy (CNB) has been recently described as an accurate second-line test in thyroid inconclusive cytology (FNA). Here we retrospectively investigated the potential improvement given by Galectin-3, Cytokeratin-19, and HBME-1 on the accuracy of CNB in thyroid nodules with prior indeterminate FNA report. The study included 74 nodules. At CNB diagnosis, 15 were cancers, 40 were benign, and 19 had uncertain/non-diagnostic CNB report. The above immunohistochemical (IHC) panel was analyzed in all cases. After surgery, 19 malignant and 55 benign lesions were found. All 15 cancers and all 40 benign nodules diagnosed at CNB were confirmed at final histology. Regarding the uncertain CNB group, 4 (21 %) were malignant and 15 (79 %) benign. When we considered all the series, the most accurate IHC combination was Galectin-3 plus HBME-1, while HBME-1 was the most sensitive marker in those nodules with uncertain CNB report. The combination of CNB plus IHC could indentify 19/19 cancers and 53/55 benign lesions. Sensitivity and specificity of CNB increased from 79 to 100 % and from 73 to 96 %, respectively, by adding IHC. CNB can diagnose the majority of thyroid nodules with previous indeterminate FNA cytology, while the accuracy of CNB is increased by adding Galectin-3, Cytokeratin-19, and HBME-1 panel. We suggest to adopt CNB as a second-line approach to indeterminate thyroid FNA, and apply IHC in those lesions with uncertain/non-diagnostic CNB report. This approach should improve the pre-surgical diagnosis of patients. These results should be confirmed in larger prospective series.
authors.affiliation: Section of Endocrinology and Diabetology, Ospedale Israelitico, Via Fulda, 14, 00148, Rome, Italy. pierpaolo.trimboli@gmail.com.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Trimboli
authors.affiliation: Section of Pathology, Ospedale Israelitico, Rome, Italy.
authors.forename: Leo
authors.initials: L
authors.lastname: Guidobaldi
authors.affiliation: Section of Endocrinology and Diabetology, Ospedale Israelitico, Via Fulda, 14, 00148, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Amendola
authors.affiliation: Section of Surgery, Ospedale Israelitico, Rome, Italy.
authors.forename: Naim
authors.initials: N
authors.lastname: Nasrollah
authors.affiliation: Department of Experimental Medicine, Sapienza University, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Romanelli
authors.affiliation: Endocrinology, Azienda Sanitaria Locale, Viterbo, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Attanasio
authors.affiliation: Department of Surgical and Medical Science, Sapienza University, Ospedale S. Andrea, Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ramacciato
authors.affiliation: Service d'Endocrinologie, Pôle de Médecine, Centre Hospitalier des Escartons, Briançon, France.
authors.forename: Enrico
authors.initials: E
authors.lastname: Saggiorato
authors.affiliation: Department of Surgical and Medical Science, Sapienza University, Ospedale S. Andrea, Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Valabrega
authors.affiliation: Section of Pathology, University Hospital Campus Bio Medico, Rome, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Crescenzi
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D062005:Biopsy, Large-Core Needle; D005260:Female; D037502:Galectin 3 / Q000032:analysis*; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000032:analysis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D013964:Thyroid Neoplasms / Q000378:metabolism / Q000473:pathology; D016606:Thyroid Nodule / Q000378:metabolism / Q000473:pathology*; D000951:Antigens, Neoplasm
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; D037502:Galectin 3; D007633:Keratins; C432845:HBME-1 antigen; D000951:Antigens, Neoplasm
keywords: Core needle biopsy (CNB); Galectin-3; Nodule; Thyroid