Abstract
Introduction
The burden of thyroid disease in general population is enormous. As many as 50% in the community have microscopic nodules1 whereas palpable nodules are encountered in 4% of the population between the age of 30-60 years2. The vast majority of thyroid nodules are non-neoplastic or benign neoplasm. The distinction between these benign neoplasms cannot be based reliably on clinical presentation only. Several diagnostic tests; such as radionuclide scanning, high resolution USG, FNAC, biopsy & immunomarkers have been used for correct evaluation. Although current diagnostic ”gold standard” for most thyroid lesions is histopathological evaluation using routine H&E stain, by expert pathologists, yet the diagnostic agreement remains controversial. One of the challenging area in surgical pathology is differential diagnosis of encapsulated follicular tumors with less than typical nuclei and equivocal signs of invasiveness3-4. This necessitates the discrimination between dominant nodule of nodular hyperplasia, follicular adenoma, minimally invasive follicular carcinoma and follicular variant of papillary carcinoma5-6. Recent studies pointed to some IHC markers in different thyroid diseases in terms of diagnostic & prognostic utility where no vascular or capsular invasion can be observed but a transformation at molecular level can be considered. Galectin-3 represents the well-studied molecular candidate for this purpose7-9. This marker has been identified in both cytoplasmic and nuclear compartment & has been implicated in cellular proliferation, apoptosis as well as malignant transformation and metastasis of cancer cells10-14.
References
- Wang C, Crapo LM: The epidemiology of thyroid disease and implications for screening. Endocrinology and metabolism clinics of North America 1997, 26(1):189-218.
- Mazzaferri EL: Management of a solitary thyroid nodule. N Engl J Med 1993, 328(8):553-55 9.
- Al-Jaradi M, Sallam A, Jabr H, Borda A, Decaussin-Petrucci M, Berger N: Prevalence of differentiated thyroid cancer in 810 cases of surgically treated goiter in Yemen. Ann Saudi Med 2005, 25(5):394-397.
- Abdeluakhab M, Mziuad O, Gavrailov M: [Thyroid cancer--its prevalence, carcinogenic factors, classifications of the cancer, types, variants amd prognostic factors]. Khirurgiia 1995, 48(2):32-38.
- Maruchi N, Furihata R, Makiuchi M: Population surveys on the prevalence of thyroid cancer in a non-endemic region, Nagano, Japan. Int J Cancer 1971, 7(3):575-583.
- Schlumberger MJ: Papillary and follicular thyroid carcinoma. N Engl J Med 1998, 338(5):297-306.
- Naganuma H, Murayama H, Ohtani N, Takaya K, Mori Y, Sakai N, Kakudo K: Optically clear nuclei in papillary carcinoma of the thyroid: demonstration of one of the fixation artifacts and its practical usefulness. Pathol Int 2000, 50(2):113-118.
- Pedio G, Hedinger C, Zobeli L: Ground-glass nuclei in papillary carcinoma of the thyroid. Acta Cytol 1981 ,25)6:(728.
- Gray A, Doniach I: Morphology of the nuclei of papillary carcinoma of the thyroid. Br J Cancer 1969, 23(1):49-51.
- Hirabayashi J, Kasai K: The family of metazoan metal-independent beta-galactoside-bindinglectins: structure, function and molecular evolution. Glycobiology 1993, 3(4):297-304.
- Dumic J, Dabelic S, Flogel M: Galectin-3: an open-ended story. Biochim Biophys Acta 2006, 1760(4):616-635.
- Paron I, Scaloni A, Pines A, Bachi A, Liu FT, Puppin C, Pandolfi M, Ledda L, Di Loreto C, Damante G et al: Nuclear localization of Galectin3 in transformed thyroid cells: a role in transcriptional regulation. Biochemical and biophysical research communications 2003, 302(3): 545-553.
- Danguy A, Camby I, Kiss R: Galectins and cancer. Biochim Biophys Acta 2002, 1572(2-3):285-293.
- Van den Brule F, Califice S, Castronovo V: Expression of galectins in cancer: a critical review. Glycoconjugate journal 2004, 19(7-9): 537-542.
- Johnson KD, Glinskii OV, Mossine VV, Turk JR, Mawhinney TP, Anthony DC, Henry CJ, Huxley VH, Glinsky GV, Pienta KJ et al: Galectin-3 as a potential therapeutic target in tumors arising from malignant endothelia. Neoplasia 2007, 9(8):662- 670.
- Sawangareetrakul P, Srisomsap C, Chokchaichamnankit D, Svasti J :Galectin-3 expression in human papillary thyroid carcinoma. Cancer genomics & proteomics 2008, 5(2):117- 122.
- Nangia-Makker P, Nakahara S, Hogan V, Raz A: Galectin-3 in apoptosis, a novel therapeutic target. Journal of bioenergetics and biomembranes 2 007, 39)1:(79- 84.
- Saxen E, Franssila K, Bjarnason O, Normann T, Ringertz N: Observer variation in histologic classification of thyroid cancer. Acta pathologica et microbiologica Scandinavica Section A, Pathology 1978, 86A(6):483-486.
- Hirokawa M, Carney JA, Goellner JR, DeLellis RA, Heffess CS, Katoh R, Tsujimoto M, Kakudo K: Observer variation of encapsulated follicular lesions of the thyroid gland. Am J Surg Pathol 2002, 26(11):1508-1514.
- Fassina AS, Montesco MC, Ninfo V, Denti P, Masarotto G: Histological evaluation of thyroid carcinomas: reproducibility of the "WHO" classification. Tumori 1993, 79(5):314-320.
- Connie G. Chiu, Scott S. Strugnell, Obi L. Griffith, Steven J.M. Jones, Allen M. Gown, Blair Walker, Ivan R. Nabi, Sam M. Wiseman. Diagnostic Utility of Galectin-3 in Thyroid Cancer. Am Journal Pathol 2010, 176:2067–2081.
- Hossein Gharib, Enrico Papini. Thyroid Nodules: Clinical Importance, Assessment, and Treatment. Endocrinology and Metabolism Clinics of North America. 2007; 36: 707- 735.
- Lei Gong, Finley, Ping Chen, Xianjun Liu, Ying Han, Yanping Zhou, Weidong Zhang, Hong Li, Chuanjia Li, Jiang Xie. Expressions of D2-40, CK19, galectin-3, VEGF and EGFR in papillary thyroid carcinoma. Gland Surgery 2012; 1(1):25-32.
- Jakubiak-Wielganowicz M, Kubiak R, Sygut J, PomorskiL,Kordek R, Usefulness of Galectin-3 Immunohistochemistry in Differential Diagnosis between Thyroid Follicular Carcinoma and FollicularAdenoma. Pol J Pathol 2003. 54 (2) : 111-115
- Juan Rosai, Giovani Tallini. Rosai and Ackerman’s surgical pathology 10thpg 487-584
- Cvejic D, Savin S, Golubovic S, Paunovic I, Tatic S & Havelka M.Galectin-3 and carcinoembryonic antigen expression in medullary thyroid carcinoma: possible relation to tumour progression. Histopathology 2000 37 530–535.
- Rabinovich GA & Rubinstein N. Galectins: a novel family of proteins involved in the regulation of the immune response. Implications in immunopathological processes. Medicine 2001 61 85–92.
- Papotti M, Volante M, Saggiorato E, Deandreio D, Veltri A & Orlandi F. Role of galectin-3 immunodetection in the cytological diagnosis of thyroid cystic papillary carcinoma. European Journal of Endocrinology 2001 147 515–521.
- Martins L, Matsuo SE, Ebina KN, Kulcsar MA, Friguglietti CU & Kimura ER. Galectin-3 messenger ribonucleic acid and protein are expressed in benign thyroid tumor. Journal of Clinical Endocrinology and Metabolism 2002 87 4806–4810.
- Niedziela M, Maceluck J & Korman E. Galectin-3 is not a universal marker of malignancy in thyroid nodular disease in children and adolescents. Journal of Clinical Endocrinology and Metabolism 2002 87 4411–4415.
- Inohara H, Honjo Y, Yoshii T, Akahani S, Yoshida J, Hattori K et al.Expression of galectin-3 in fine-needle aspirates as a diagnostic marker differentiating benign from malignant thyroid neoplasms. Cancer 1999 85 2475 2484.
- Iurisci I, Tinari N, Natoli C, Angelucci D, Cianchetti E & Iacobelli S. Concentrations of galectin-3 in the sera of normal controls and cancer patients. Clinical Cancer Research 2000 4 1389–1393.
- Weber KB, Shroyer KR, Heinz DE, Nawaz S, Said MS, Haugen BR. The use of a combination of galectin-3 and thyroid peroxidase for the diagnosis and prognosis of thyroid cancer. Am J Clin Pathol.2004;122:524-31(PubMed) (Google Scholar)
- Herrmann ME, LiVolsi VA, Pasha TL, Roberts SA, Wojcik EM, Baloch ZW. Immunohistochemical expression of galectin-3 in benign and malignant thyroid lesions. Arch Pathol Lab Med. 2002; 126: 710-13.(PubMed) (Google Scholar)
- Rita Beata Kovacs, Janos Folde European Journal of Pathology, 2003,149 449-453.
Corresponding Author
Dr Arpita Dhal
PG student, Dept.of Pathology, HMCH Bhubaneswar, Odisha, India