European Journal of Molecular & Clinical Medicine

Abstract

Background:To distinguish between malignant and benign lesions of the thyroid gland and due to several overlapping histomorphological features and pitfalls in thyroid pathology, there is a need to establish a panel of immunomarkers that could aid in proper diagnosis. This study is intended to investigate the ability of CK-19 & HBME-1 in differentiating between benign and papillary carcinoma thyroid
Methods: This study is being conducted in the Department of Pathology, Kakatiya Medical College and MGM hospital, Warangal, Telangana during a period between 2018 to 2021. A total of 60 cases are studied out of which 32 cases were diagnosed as follicular adenoma, 16were PTC, and 12 were FVPTC. Excision biopsies specimens from the lesions were fixed in formalin, paraffin-embedded, and routinely stained in H and E. IHC staining with markers HBME - 1 and CK-19 was done and their expression is correlated.
Results: The highest incidence of thyroid nodules in the present study was in the 4th decade in males. Papillary Thyroid Carcinoma (PTC) was most common in malignant thyroid nodules, out of 28 malignant lesions selected 16 were classic PTC and 12 were FVPTC. Positive CK19 expression observed in 25 out of 28 malignant cases (89.28%) included 15 out of 16 cases of classic PTC (93.75%). Positive HBME-1 expression observed in 27 out of 28 malignant cases (96.4%) included 16 out of 16 cases of classic PTC (100%) and 11 out of 12 cases of FVPTC (91.6%). Negative HBME-1 expression was observed in 1 case out of 12 FVPTC (3.5%). Negative HBME-1 expression was observed in 26 out of 32cases (81.25%) of benign lesions. HBME-1 showed a high statistically significant difference between papillary carcinoma of the thyroid and other benign thyroid nodules (P < 0.000001).
 
Conclusion: Conventional PTC may not pose a problem for diagnosis but its variants and its benign morphological mimics are challenging. Our study concurs with published literature to suggest strong expression of CK19 and HBME-1 in FVPTC and PTC. CK19 and HBME-1 are impressive positive markers for malignant lesions probably helping in the new category of encapsulated follicular pattern thyroid nodules.