Objective: It is beneficial to distinguish non- invasive follicular thyroid neoplasm with papillary-like
nuclear features (NIFTP) from other follicular-based lesions like follicular variant of papillary thyroid
carcinoma (FVPTC) and follicular adenoma (FA). Galectin-3 plays a role in normal development and
tumorigenesis. Cytokeratin 19 (CK19) overexpression is linked to neoplastic transformation. PD-L1
functions as a negative immune regulator. Hypoxia-inducible factor (HIF-1α) plays a role promoting
angiogenesis.
Aim: Evaluation role of Galectin-3, CK19, PD-L1 and HIF-1α immunoexpressions in distinguishing
between benign follicular nodule (BFN), NIFTP and FVPTC with correlation to different
clinicopathological variables hoping to find new diagnostic and therapeutic methods.
Material and Methods: This retrospective study was done on 45 cases of different thyroid follicular
patterned lesions as follow: 25 BFN, 6 NIFTPs, and 14 cases of FVPTCs. Immunohistochemical staining
was used to detect Galectin-3, CK19, PD-L1 and HIF-1α expressions in distinguishing those follicular
patterned thyroid lesions.
Results:
PD-L1, Galectin-3 and CK19 showed the highest sensitivity and specificity in distinguishing FVPTCs
from BFNs and NIFTPs when used individually. In many configurations, the panel made up of the four
markers (positive Galectin-3, positive CK19, positive PD-L1 and high HIF-1α) showed the highest
specificity and sensitivity (100% and 88.4% correspondingly). PD- L1 was the most sensitive marker
(92.8%), whereas Galectin-3 and CK19 were the most specific (80%) to discriminate FVPTCs from
BFNs and NIFTPs.
Conclusion: The co-expression of Galectin-3, CK19, PD-L1, and HIF-1α increased specificity and
sensitivity (100% and 88.4% respectively) while differentiating FVPTCs from BFNs and NIFTPs. |
