DIAGNOSTIC UTILITY OF GALECTIN-3 AND CK 19 IN DIFFERENTIATING PAPILLARY THYROID CARCINOMA FROM NON-NEOPLASTIC LESIONS OF THYROID" at R L JALAPPA HOSPITAL AND RESEARCH CENTRE, KOLAR

Abstract

BACKGROUND: Thyroid neoplasm is one of the most common endocrine neoplasm. Papillary thyroid carcinomas (PTC) are most commonly encountered thyroid malignancies. Diagnosis of PTC is based on the special nuclear features like, anisonucleosis, overlapping of nuclei, intranuclear inclusions, optical clearing and nuclear grooves. However, some of these features may also be seen in benign thyroid lesions secondary to degeneration. As differentiation between benign or malignant lesions has clinical, therapeutic and prognostic significance, it’s necessary to make precise diagnosis by using biomarkers. In recent years many immunohistochemical (IHC) biomarkers have been studied to aid in the differentiation between non-neoplastic and malignant thyroid lesions. CK19, Galectin 3, TG, Ki67, BRAF, Calcitonin, HBME-1, TTF1 and RET are some of the examples of these IHC markers. Inspite of several studies being done related to the utility of these biomarkers in singles as well as various combinations, a uniform consensus is yet to be reached. AIMS AND OBJECTIVES: To determine the expression of CK 19 and Galectin-3 in Papillary thyroid carcinoma and non-neoplastic lesions of thyroid. To compare the expression of Galectin-3 and CK19 in papillary thyroid carcinoma and non-neoplastic lesions of thyroid. XIX MATERIALS AND METHODS: This is an observational study. 26 cases with papillary thyroid carcinoma and 26 cases of non-neoplastic lesions of thyroid were studied. Relevant clinical data was collected. H&E slides were reviewed and selection of paraffin blocks with lesional area were selected. IHC for CK 19 and Gal 3 were performed. The expression of both the biomarkers were scored, analysed and compared. Specificity and sensitivity was evaluated for each biomarker and their combination. P value of <0.05 was considered statistically significant. RESULTS: The specificity and sensitivity of CK 19 to differentiate papillary thyroid carcinoma and non-neoplastic lesions of thyroid was 88.46% and 23.08% respectively. The specificity and sensitivity for Gal 3 was 88.46% and 50% respectively. The specificity and sensitivity for the combination of CK19 and Gal 3 biomarker was 84.62 and 61.54% respectively. CONCLUSION: The present study concludes that Gal 3 can be useful to differentiate PTC and non-neoplastic lesions of thyroid. CK 19 and the combination of CK19 and Gal 3 biomarkeris not helpful to differentiate PTC and non-neoplastic lesions of thyroid.