Usefulness of Cytokeratin-19, Galectin-3, and Hector Battifora Mesothelial-1 in the Diagnosis of Benign and Malignant Thyroid Nodules

Background: Having been asymptomatic, most thyroid nodules are found incidentally. In the absence of a specific diagnostic marker of malignant thyroid nodules, it is difficult to microscopically diagnose the benign or malignant nature of nodules. Methods: In the present study, the goal is to investigate the expression of cytokeratin-19 (CK-19), galectin-3 (Gal-3), and Hector Battifora mesothelial-1 (HBME-1) in thyroid nodules, and to assess their diagnostic value as markers in the differential diagnoses of benign and malignant thyroid nodules. Conventional Immunohistochemistry (IHC) was used on formalin-fixed, paraffin-embeded blocks of 150 cases of benign and malignant thyroid lesions. The benign group included 28 cases of follicular adenoma (FA) and 44 cases of thyroid nodular goiter. The malignant group included 72 cases of papillary thyroid carcinoma (PTC) and 6 cases of follicular thyroid carcinomas (FTC). Results: It was statistically found that there were strikingly significant differences for the three markers in the distinguishing diagnosis of malignant and benign thyroid nodules (p<0.01). However, there were no significant differences for the expression of the three markers among two different subtypes in the malignant group. What is more, no significant relationship was found between the expression of CK-19, Gal-3, or HBME-1 and gender, age, tumor size, focal lymphocytic infiltration, or lymph node metastasis in thyroid nodules. Conclusions: The combined use of CK19, Gal-3, and HBME-1 is of practical value in the diagnosis and differential diagnosis of benign and malignant thyroid nodules. (Clin. Lab. 2012;58:673-680. DOI: 10.7754/Clin.Lab.2011.110917)