Diagnostic value of HBME-1, COX-2 and CK19 in the differential diagnosis of thyroid lesions

ABSTRACT

The distinction between benign and malignant thyroid tumors is critical for the management of patients with thyroid nodules. We applied immunohistocmhem1ical stainig for HBMF-1, COX-2 and CK19 to determine their diagnostic accuracy in diagnosis of thyroid lesions. The expression was significantly associated with thyroid carcinoma. The sensitivity was 77.8% with HBME-1, 100% with COX-2 and 100% with CK19 for papillary carcinoma 80% with HBME-1, 60% with COX-2 and 100%with CK19 for follicular carcinoma. The specificity of these antibodies was 100% for thyroid carcinoma included in this study. Comparing papillary carcinoma with papillary hyperplasia, the three antibodies were significantly expressed in papillary carcinoma. Comparing follicular variants of papillary carcinoma with follicular carcinoma, the expression of CK19 was significantly higher in follicular variants of papillary carcinoma, while COX-2 was higher in follicular carcinoma, comparing follicular carcinoma with follicular adenoma, the expression of COX-2 and HBME-1 was significantly higher in follicular carcinoma, we suggest that [1] COX-2 and HBME-1 positivity may indicate malignancy in thyroid lesions. [2] Diffuse CK19 positivity can aid in the differential diagnosis of classic papillary carcinoma and follicular variants of papillary carcinomas vs. follicular carcinoma and other benign thyroid lesions mimickers. [3] COX-2 expression may serve as useful molecular marker for cases of follicular carcinoma with diagnostic difficulty