Expressions of CK-19, NF-kappaB, E-cadherin, beta-catenin and EGFR as diagnostic and prognostic markers by immunohistochemical analysis in thyroid carcinoma.

Immunohistochemical markers have been proposed for thyroid cancer diagnosis and prognostic studies. Immunohistochemical analysis of CK-19, NF-kappaB, beta-catenin, E-cadherin and EGFR were done to evaluate their diagnostic and prognostic efficiencies in eighty eight cancer specimen (PTC-52, FTC-16, benign nodule-12 and MNG-8). CK-19 was positive in 91% (62/68) DTC, 98% (51/52) PTC, 69% (11/16) FTC and 15% (3/20) benign thyroid nodules. NF-kappaB was expressed 93% (63/68) DTC, in 96% (50/52) PTC, 81% (11/16) FTC and 15% (3/20) benign thyroid nodules. Both CK-19 and NF-kappaB were significantly differentiated DTC, PTC and FTC from benign thyroid nodule (p < 0.0001) with diagnostic accuracy of 89.74%, 94.4% and 77.4% for CK-19 and 91.0%, 90.5% and 83.5% respectively for NF-kappaB. Though CK-19 and NF-kappaB were equally sensitive but CK-19 was most specific in the diagnosis of DTC and PTC. The diagnostic accuracy of beta-catenin was 96% and 94% and accuracy of E-cadherin was 90.1% and 93.9% for the diagnosis of metastatic PTC and FTC respectively. EGFR showed 90% (18/20) of metastatic PTC (p < 0.0001) and sensitivity, specificity and accuracy were 90%, 71.8% and 78.85% respectively. CK-19 and NF-kappaB were accurately diagnosed in DTC, PTC and FTC whereas, NF-kappaB, E-cadherin, beta-catenin and EGFR were strongly expressed in invasive papillary thyroid cancers and FTC, thus can be important diagnostic and prognostic marker for FTC and metastatic PTC. This may be concluded that immunohistochemical expression of panel of markers CK-19, NF-kappaB, E-cadherin, beta-catenin and EGFR can be useful in diagnosis and prognosis of DTC.

Biomarkers for the diagnosis of thyroid cancer.

Thyroid tumor contributes 1% of the total tumor but 90% of the endocrine related tumors. Majority of the thyroid cancers are being diagnosed by Fine needle aspiration cytology (FNAC) and histology. Although histology is considered as gold standard, it has some limitations, like variants of papillary and follicular cancer creates confusion among pathologists, where the morphological features are indistinguishable. Conventional histology and FNAC fails to provide any prognostic and therapeutic information. To address this problem, several immunohistochemical markers are proposed and their efficiency in thyroid cancer diagnosis, treatment and prognosis are being evaluated. Among the discussed immunohistochemical markers, few have potential in accurate diagnosis and prognosis of thyroid carcinoma. Hector battifora mesothelial antigen-1 (HBME-1) and Galectin-3 (GAL-3) shows highest specificity and sensitivity in the diagnosis of thyroid cancer respectively. Overexpression of EGFR in thyroid cancer is in proportionate with the severity of the advanced thyroid carcinoma, which required further evaluation and validation. Surgery and radio-iodine therapy is the main treatment modality, however; combined targeted therapeutic approach against different thyroid cancer receptor and biomarkers can reduce the side effect, and improve therapeutic efficiency. This review is oriented towards the finding of the potent thyroid cancer receptor having enhanced sensitivity and specificity, with diagnostic, prognostic and therapeutic efficiency.