Background &Objectives: thyroid nodule management depends mainly on fine needle aspiration
cytology (FNAC) to bear out its nature. Yet, in particular cases, differentiation between benign and
malignant thyroid nodules represents a diagnostic problem. Our aim is to investigate the diagnostic
utility of cyclinD1, galactin3, and CK19 immunostains in resolving this issue as the financial and
emotional load of malignancy management is particularly considerable.
Material and methods: our study included 60 patients presented with nodular thyroid enlargement.
After surgery, 30 cases diagnosed histologically as follicular adenomas (FA) and 30 cases diagnosed
as papillary thyroid carcinomas (PTC). Immunohistochemical study of the aforementioned markers
was performed in both groups. The best cutoff level and the diagnostic performance of single or
combinations of these immunohistochemical markers were calculated by using the receiver
operating characteristic (ROC) curve analysis.
Results: signal intensities for galactin3, CK19 and cyclinD1 were significantly greater in PTC
compared with FA. The combination of K19/cyclinD1 exhibit ed the highest performance to assess
the diagnosis of malignancy with overall diagnostic accuracy was 99.2%, with 90.3% sensitivity,
100% specificity, 100% PPV and 90.8%NPV.
Conclusion and recommendation: our findings advocate that a combination of K19 / cyclinD1
markers may increase the reliability of identification of thyroid malignancy. We recommend more
studies on cyclinD1 expression in wider thyroid lesions and more precise statistical results with a
higher number of cases. |
