The Usefulness of Immunocytochemistry of CD56 in Determining Malignancy from Indeterminate Thyroid Fine-Needle Aspiration Cytology
The Usefulness of Immunocytochemistry of CD56 in Determining Malignancy from Indeterminate Thyroid Fine-Needle Aspiration Cytology
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Background Fine-needle aspiration cytology serves as a safe, economical tool in evaluating thyroid nodules.However, about 30% of the samples are categorized as indeterminate.Hence, many immunocytochemistry markers have been studied, but there has not been a single outstanding marker.
We studied the efficacy of CD56 with alesis vi61 human bone marrow endothelial cell marker-1 (HBME-1) in diagnosis in the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) category III.Methods We reviewed ThinPrep liquid-based cytology (LBC) samples with Papanicolaou stain from July 1 to December 31, 2016 (2,195 cases) and selected TBSRTC category III cases (n = 363).Twenty-six cases were histologically confirmed as benign (six cases, 23%) or malignant (20 cases, 77%); we stained 26 LBC slides with HBME-1 and CD56 through the cell transfer method.
For evaluation of reactivity of immunocytochemistry, we chose atypical follicular cell clusters.Results CD56 was not reactive in 18 of 20 cases (90%) of malignant nodules and showed cytoplasmic positivity in five of six cases (83%) of benign nodules.CD56 showed high sensitivity (90.
0%) and relatively low specificity (83.3%) in detecting malignancy (p =.004).
HBME-1 was reactive in 17 of 20 cases (85%) of malignant nodules and was not reactive in five of six cases (83%) of benign nodules.HBME-1 showed slightly lower sensitivity (85.0%) than CD56.
The specificity black knight darts in detecting malignancy by HBME-1 was similar to that of CD56 (83.3%, p =.008).
CD56 and HBME-1 tests combined showed lower sensitivity (75.0% vs 90%) and higher specificity (93.8% vs 83.
3%) in detecting malignancy compared to using CD56 alone.Conclusions Using CD56 alone showed relatively low specificity despite high sensitivity for detecting malignancy.Combining CD56 with HBME-1 could increase the specificity.
Thus, we suggest that CD56 could be a useful preoperative marker for differential diagnosis of TBSRTC category III samples.