Immunohistochemical markers in the diagnosis of papillary thyroid carcinomas: The promising role of combined immunostaining using HBME-1 and CD56

Pathol Res Pract. 2013 Sep;209(9):585-92. doi: 10.1016/j.prp.2013.06.012. Epub 2013 Jul 8.

Abstract

We aimed to evaluate the expression and diagnostic value of five immunohistochemical markers (HBME-1, Galectin-3, CK19, CD56 and p63) in a very large series of unequivocal papillary thyroid carcinoma (PTC) cases, including both the classic (CPTC) and the follicular variant (FVPTC). We performed an immunohistochemical analysis on a tissue micro-array of 204 PTCs (98 CPTCs, 90 FVPTCs, and 16 other variants). HBME-1 was the most sensitive marker, staining 95.9% of CPTCs and 81.1% of FVPTCs. CD56, a marker whose expression is reduced or absent in thyroid carcinoma, revealed a negative, "malignant" profile in 93.9% of CPTCs and 73.3% of FVPTCs. Galectin-3, CK19 and p63 were positive in 64.7%, 45.6% and 6.9% of PTCs, respectively. The immunopanel consisting of HBME-1, CD56 and/or CK19 reached the highest sensitivity (95.6%). The co-expression of 2 or more proteins was observed in 88.2% of PTCs, with HBME-1 and CD56 being the most frequent positive association (79.4%). We report a new panel of antibodies consisting of HBME-1, CK19 and CD56 that was found to be highly sensitive for both CPTC and FVPTC. This panel could be recommended as a supplement to the morphological criteria in the diagnosis of difficult FVPTC cases.

Keywords: CD56 antigen; HBME-1 antigen; Immunohistochemistry; Papillary; Thyroid cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma, Papillary / diagnosis*
  • Adenocarcinoma, Papillary / metabolism
  • Adult
  • Biomarkers, Tumor / analysis*
  • Biomarkers, Tumor / biosynthesis
  • CD56 Antigen / analysis
  • CD56 Antigen / biosynthesis*
  • Female
  • Humans
  • Immunohistochemistry / methods
  • Keratin-19 / analysis
  • Keratin-19 / biosynthesis
  • Male
  • Sensitivity and Specificity
  • Thyroid Neoplasms / diagnosis*
  • Thyroid Neoplasms / metabolism
  • Tissue Array Analysis

Substances

  • Biomarkers, Tumor
  • CD56 Antigen
  • HBME-1 antigen
  • Keratin-19
  • NCAM1 protein, human