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Category: Volume 06 Issue 02 February 2018
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Title: Application of CK 19 and CD 56 Immunohistochemical Markers in the Diagnosis of Thyroid Tumors

Authors: Dr Niti Dalal, Dr Uma Sharma, Dr Sweta, Dr Irbinder Kour Bali

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i2.176

Abstract

Objectives: Immunohistochemical expression of CK19 and CD56 was studied in the differential diagnosis of thyroid tumors as Papillary Carcinoma is the most common thyroid cancer which needs to be differentiated from other Benign follicular lesions and to identify Follicular Variant of Papillary Carcinoma. The aim of this study is to evaluate the immunohistochemical expression of CK19 and CD56 and its correlation with histopathological profile of thyroid tumors.

Methods: The study was carried out at SGT Medical College and Hospital, Gurugram which included 24 cases of thyroidectomy specimens (including Follicular Adenoma, Hurthle Cell Adenoma, Papillary Carcinoma) over a time period of two years. Cases of Follicular Carcinoma and Hurthle Cell Carcinoma were also included. Hematoxylin and Eosin staining and immunohistochemical staining for CK19 and CD 56 were done as per standard protocol.

Results: The positive expression of CK19 in patients with Papillary Carcinoma was significantly higher than other thyroid lesions. CD56 expression was seen in 41% of benign neoplasms and in 8.4% of malignant neoplasms, out of all Neoplastic lesions. The sensitivity and specificity of CK19 and CD 56 found out to be statistically significant.

Conclusion: Expression of CK19 and CD56 is helpful in differentiating Papillary Carcinoma from other thyroid tumors.

Keywords: Benign thyroid lesions, CD56, CK19, Papillary carcinoma, Thyroid tumors.

References

  1. Sethi K, Sarkar S, Das S, Rajput S, Mazumder A, Roy B, Patra S, Mohanty B, El-Naggar AK, Mandal M. Expressions of CK-19, NF-κB, E-Cadherin, β- Catenin and EGFR as diagnostic and prognostic markers by immunohistochemical analysis in thyroid carcinoma. J Exp Ther Oncol. 2011;9(3):187-99.
  2. Saravi OE, Torabizadeh Z, Amirkhani S. The Role of CD56 in distinction of PTC from other thyroid neoplasms. Int J Med Invest. 2015;4(4):385-90.
  3. Mokhtari M, Eftekhari M, Tahririan R. Absent CD56 expression in papillary thyroid carcinoma: A finding of potential diagnostic value in problematic cases of thyroid pathology. J Res Med Sci. 2013;18(12):1046–
  4. Demellawy DE, Nasr A, Alowami S. Application of CD56, P63 and CK19 immunohistochemistry in the diagnosis of papillary carcinoma of the thyroid. Diagn Pathol. 2008;3:5.
  5. Matos LLD, Giglio ABD, Matsubayashi CO, Farah MDL, Giglio AD, Pinhal MADS. Expression of CK-19, Galectin-3 and HBME-1 in the differentiation of thyroid lesions: systematic review and diagnostic meta-analysis. Diagn Pathol. 2012;7:97.
  6. Dunđerović D, Lipkovski JM, Boričic I, Soldatović I, Božic V, Cvejić D, Tatić S. Defining the value of CD56, CK19, Galectin 3 and HBME-1 in diagnosis of follicular cell derived lesions of thyroid with systematic review of literature. Diagn Pathol. 2015;10:196.
  7. Shin MK, Ju JWKY. CD56 and High Molecular Weight Cytokeratin as Diagnostic Markers of Papillary Thyroid Carcinoma. Korean J Pathol. 2011;45:477-84.
  8. Ozolins A, Narbuts Z, Strumfa I, Volanska G, Stepanovs K, Gardovskis J. Immunohistochemical expression of HBME-1, E-cadherin, and CD56 in the differential diagnosis of thyroid nodules. Medicina (Kaunas). 2012;48(10):507-14.
  9. Wu G, Wang J, Zhou Z, Li T, Tang F. Combined staining for immunohistochemical markers in the diagnosis of papillary thyroid carcinoma: Improvement in the sensitivity or specificity. J Int Med Res. 2013;41(4):975-83.
  10. Ramesh VL, Sunitha S, Rupnarayan R, Murthy CN. Patterns of Thyroid Lesions: A Histomorphological Study. Global J Med Res. 2014;14(6):29-34.
  11. Wani LA, Banday BM, Ashraf A, Ashai FB, Reshi R. Histopathological pattern of thyroid lesions reported in a tertiary care hospital in kashmir: a 3- year retrospective review. Int J Cur Res. 2015;7(11):22763-7.
  12. Kolur A, Anitha B, Letha P, Joshi T, Jayasree, Ahmed S, Naik H. Pattern of thyroid disorder in thyroidectomy specimen. Int J Med Sci Public Health. 2014;3(12): 1446-48.
  13. Rahman MA, Biswas MA, Siddika ST, Sikder AM, Talukder SI, Alamgir MH. Histomorp-hological Pattern of Thyroid Lesion. Dinajpur Med Col J. 2013;6(2):134-40.
  14. Joseph E, Varghese A, Celine TM, Matthai A, Poothiode U. A study on the histopathological pattern of thyroid lesions in a tertiary care hospital. Int J Res Med Sci. 2016;4(12): 5252-5.
  15. Gupta A, Jaipal D, Kulhari S, Gupta N. Histopathological study of thyroid lesions and correlation with ultrasonography and thyroid profile in western zone of Rajasthan, India. Int J Res Med Sci. 2016;4(4):1204-8.
  16. Patil RP, Nimbal NV, Pratima S, Patil SR, Sreekantha, Remya. Histopathological Study Of Thyroid Lesions. Int J Pharm Bio Sci. 2013;4(4):1003-20.
  17. Prasad ML, Pellegata NS, Huang Y, Nagaraja HN, Chapelle ADL, Kloos RT. Galectin-3, Fibronectin-1, CITED-1, HBME1 and Cytokeratin-19 immunohistochemistry is useful for the differential diagnosis of thyroid tumors. Mod Pathol. 2005;18:48–
  18. Matos PSD, Ferreira AP, Facuri FDO, Assumpcao LVM, Metze K, Ward LS. Usefulness of HBME-1, cytokeratin 19 and galectin-3 immunostaining in the diagnosis of thyroid malignancy. Histopathology. 2005;47(4):391–
  19. Erkiliç S, Aydin A, Koçer NE. Diagnostic utility of cytokeratin 19 expression in multinodular goiter with papillary areas and papillary carcinoma of thyroid. Endocr Pathol. 2002;13(3):207-11.
  20. Erkiliç S, Koçer NE. The Role of Cytokeratin 19 in the Differential Diagnosis of True Papillary Carcinoma of Thyroid and Papillary Carcinoma-like Changes in Graves’ Endocr Pathol. 2005;16(1).63-6.
  21. Park MI, Kang DY. Usefulness of Galectin-3, Cytokeratin 19, p53, and Ki-67 for the Differential Diagnosis of Thyroid Tumors. Korean J Pathol. 2006;40:86-92.
  22. Sahoo S, Hoda SA, Rosai J, DeLellis RA. Cytokeratin 19 Immunoreactivity in the Diagnosis of Papillary Thyroid Carcinoma. Am J Clin Pathol. 2001;116:696-702.
  23. Saleh HA, Jin B, Barnwell J, Alzohaili O. Utility of immunohistochemical markers in differentiating benign from malignant follicular derived thyroid nodules. Diagn Pathol. 2010;5:9.
  24. Zhu X , Sun T, Lu H, Zhou X, Lu Y, Cai X, Zhu X. Diagnostic significance of CK19, RET, galectin-3 and HBME-1 expression for papillary thyroid carcinoma. J Clin Pathol. 2010;63(9):786-9.
  25. Krzeslak A, Gaj Z, Pomorski L, Lipinska A. Expression of cytokeratin 19 in the cytosolic fraction of thyroid lesions: ELISA and Western blot analysis. Mol Med Rep. 2008;1:565-9.
  26. Atti RMAE, Shash LS. Potential diagnostic utility of CD56 and claudin-1 in papillary thyroid carcinoma and solitary follicular thyroid nodules. J Egypt Natl Cancer Inst. 2012;24:175–
  27. Park WY, Jeong SM, Lee JH, Kang HJ, Sin DH,Choi KU, Park DY, Huh GY, Sol MY, Lee CH. Diagnostic value of decreased expression of CD56 protein in papillary carcinoma of the thyroid gland. Basic Appl Pathol. 2009;2:63–
  28. Demellawy DE, Nasr AL, Babay S, Alowami S. Diagnostic utility of CD56 immunohisto-chemistry in papillary carcinoma of the thyroid. Pathol Res Pract. 2009;205(5):303–
  29. Shahebrahimi K, Madani SH, Fazaeli AR, Khazaei S, Kanani M, Keshavarz A. Diagnostic value of CD56 and nm23 markers in papillary thyroid carcinoma. Indian J Pathol Microbiol. 2013;56(1):2-5.

Corresponding Author

Dr. Niti Dalal

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