The Expression of HBME1, PAX8, CD56 and CITED1 in Benign Lesions, Benign and Malignant Tumors of Thyroid

INTRODUCTION: To evaluate the role of HBME1, PAX8, CD56 and CITED1 in distunguishing benign lesions of the thyroid from malignant tumors and different malignant tumors of the thyroid.
METHODS: The patients that underwent thyroidectomy between 2007 and 2013 were included to the study. Patients with Nodular Hyperplasia: 22, Folicular Adenoma: 14, Noninvasive Folicular Thyroid Neoplasm With Papillary-Like Nuclear Features: 3, Well Diferentiated Carcinoma, Not Otherwise Specified: 3, Papillary Carcinoma: 22, Papillary Carcinoma Folicular Variant: 12, Minimally Invasive Folicular Carcinoma: 9, Poorly Diferentiated Carcinoma: 4, Anaplastic Carcinoma: 3 were included to the study. HBME1, CITED1, PAX8, CD56 were applied by immunohistochemical method. In statistical analysis, the sensitivity, specificity, positive predictive and negative predictive values of markers were calculated.
RESULTS: CD56 (loss of expression), HBME1 was significantly higher in Papillary Carcinoma, Papillary Carcinoma Folicular Variant compared to other malignant neoplasms. The most sensitive markers for malignant tumors were PAX8 and CITED1 (90%, 88% ). The most specific markers for malignant tumors were HBME1, CITED1 (97%, 92% ). The most sensitive and specific marker for Papillary Carcinoma, Papillary Carcinoma Folicular Variant was HBME1 (100%, 80%). CD56 (loss of expression), CITED1 was the most sensitive markers for Papillary Carcinoma Folicular Variant ( 86%,86%).
DISCUSSION AND CONCLUSION: HBME1 was found an both sensititive and specific marker for Papillary Carcinoma. The cytoplasmic expression of CITED1 was significantly higher in PC compared to other malignant tumors. Nuclear expression of PAX8 was found significantly higher in benign cases compared to malignant tumors. HBME1,CD56 (loss of expression) was found significantly higher in Papillary Carcinoma, Papillary Carcinoma Folicular Variant compared to other malignant tumors.

Tiroidin Benign Lezyonlarý, Benign ve Malign Tümörlerinde HBME1, PAX8, CD56 ve CITED1 Ekspresyonun Deðerlendirilmesi

GÝRÝÞ ve AMAÇ: HBME1, PAX8, CD56 ve CITED1’ in tiroidin benign lezyonlarýný, malign tümörlerden ve tiroidin farklý malign tümörlerini birbirinden ayýrt etmedeki rolünü deðerlendirmektir.

YÖNTEM ve GEREÇLER: 2007-2013 yýllarý arasýnda tiroidektomi yapýlan Nodüler Hiperplazi: 22, Foliküler Adenoma: 14, Papiller Benzeri Nükleer Özellikler Gösteren non-Ýnvaziv Foliküler Tiroid Neoplazmý: 3, Ýyi Diferansiye Karsinoma, Spesifiye Edilememiþ: 3, Papiller Karsinoma: 22, Papiller Karsinoma, Foliküler Varyant: 12, Minimal Ýnvaziv Foliküler Karsinoma: 9, Az Diferansiye Karsinoma: 4, Anaplastik Karsinoma: 3 çalýþmaya dahil edildi. Ýmmünhistokimyasal yöntem ile HBME1, CITED1, PAX8, CD56 uygulandý. Ýstatistiksel analizde markerlerýn duyarlýlýk, özgüllük, pozitif ve negatif prediktif deðerleri hesaplandý.
BULGULAR: CD56 (ekspresyon kaybý), HBME1, Papiller Karsinoma ve Papiller Karsinoma, Foliküler Varyantta, diðer malign tümörlere göre anlamlý yüksekti. Malign tümörler için en duyarlý markerlar PAX8 ve CITED1( %90, %88) idi. Malign tümörler için en spesifik markerlar HBME1, CITED1 (%97, %92)idi. Papiller Karsinoma, Papiller Karsinoma, Foliküler Varyant için en duyarlý ve spesifik marker HBME1 (%100, %80) idi. Papiller Karsinoma, Folliküler Varyant için en duyarlý markerlar CD56 (ekspresyon kaybý) ve CITED1 (%86, %86)idi.
TARTIÞMA ve SONUÇ: HBME1, Papiller Karsinoma için duyarlý ve spesifik bulundu. CITED1’in sitoplazmik ekspresyonun Papiller Karsinomada, tiroidin diðer malign tümörlerine göre anlamlý þekilde yüksekti. PAX8'in nükleer ekspresyonu benign olgularda malign olgulara göre anlamlý þekilde yüksek bulundu. HBME1, CD56 (ekspresyon kaybý), Papiller Karsinoma ve Papiller Karsinoma, Foliküler Varyantta diðer malign tümörlere göre anlamlý þekilde yüksek bulundu.