The Expression And Diagnostic Value Of CITED-1?Galectin-3?CK19?HBME-1 In Differentiated Thyroid Carcinoma

ObjectiveTo explore the expression of CITED-1,CK19,Galectin-3 and HBME-1 in papillary thyroid carcinoma(PTC)?follicular thyroid carcinoma(FTC)?follicular adenoma(FA)and nodular goiter(NG),and the value of the four immunohistochemical markers single or combined detection in differential diagnosis of differentiated thyroid carcinoma(DTC).To provid valuable basis for the pathological diagnosis.MethodsAll the samples were selected from the Pathology Department of Zhangzhou Municipla Hospital,including 88 papillary thyroid carcinomas(PTC)?12 follicular thyroid carcinomas(FTC)?57 follicular adenomas(FA)and 36 nodular goiters(NG).Immunohistochemical staining combined with the technology of tissue chip were performed in the selected specimens to examine the expression of CITED-1?Galectin-3?CK19 and HBME-1.To evaluate the diagnostic value of the four immunohistochemical markers in the diagnosis of PTC and FTC.All the results were analyzed by SPSS18.0 statistical software and the level of significant difference was P<0.05.Results1.The positive expression rates of CITED-1 in PTC?FTC?FA and NG were 97.9%?91.7%?21.1%?8.3%.The positive expression rates of CITED-1 in PTC?FTC were higher than those in FA and NG,and the difference was statistically significant(p<0.05);The positive expression rates of Galectin-3 in PTC?FTC?FA and NG were 94.3%?50%?10.5%?2.8%.The positive expression rates of Galectin-3 in PTC and FTC were higher than those in FA and NG,and the difference was statistically significant(p<0.05);The positive expression rates of CK19 in PTC?FTC?FA and NG were95.5%?100%?47.4%?33.3%.The positive expression rates of CK19 in PTC and FTC were higher than those in FA and NG,and the differences in PTC?FTC and FA?NG was statistically significant(p<0.05).The positive expression rates of HBME-1 in PTC?FTC?TA and NG were 88.6%?91.7%?5.3%?2.8%.The positive expression rates of HBME-1 in PTC?FTC and FA?NG were higher than those in FA and NG,and the difference in PTC?FTC and FA?NG was statistically significant(p<0.05).2.The sensitivity of CITED-1?Galectin-3?CK19 and HBME-1 on the diagnosis of PTC were 97.7%?94.3%?95.5%?88.6%,and the specificity were75.2%?87.6%?51.4%?85.7%,respectively.Compared of the four markers,Galectin-3 has the highest diagnostic accuracy of 90.7%,and its area under ROC curve was the highest(AUROC=0.910;95%CI,0.863-0.956),while HBME-1 was the second(AUROC=0.872;95%CI,0.817-0.926),and CITED-1 was the third(AUROC=0.865;95%CI,0.811-0.919).3.When the coexpression were adopted as the diagnostic criteria of PTC,the combination of Galectin-3 and HBME-1 had a higher specificity of 95.2%(AUROC=0.914;95%CI,0.867-0.961)and the combination of Galectin-3 and CK19 also had a higher specificity of 94.3%(AUROC=0.92;95%CI,0.875-0.965),with the highest diagnostic accuracy.If the expression of any two markers in a combination of three markers were considered as the diagnostic criteria of PTC,the combination of CITED-1?CK19 and Galectin-3 had a sensitivity and negative predictive value of 100% respectively,but the specificity and AUROC were without any rising.4.The expression of CITED-1 in PTC was not related to gender,age,tumor size and lymph node metastasis;The expression of Galectin-3 in PTC was related to lymph node metastasis(P<0.05),but had no correlation to sex,age and tumor size.The expression of CK19 in PTC was related to gender,but had no correlation to age,tumor size and lymph node metastasis;The expression of HBME-1 was related to tumor size,lymph node metastasis(P<0.05),but had no correlation to gender and age.Conclusions1.There was certain value of CITED-1 on the diagnosis of PTC;Galectin-3 had the highest diagnostic value,while HBME-1 the second and CITED-1 the third,both higher than CK19,When the markers were detected singly to diagnose PTC.2.Galectin-3 combined with CK19 and Galectin-3 combined with HBME-1 were the most valuable in our study.If the expression of any two markers in a combination of three markers were consider as the diagnostic criteria of PTC,the combination of CITED-1?CK19 and Galectin-3 had a negative predictive value of 100%,which can rule out PTC preliminarily.3.CITED-1?Galectin-3? CK19 and HBME-1 had certain reference value in the differential diagnosis of FTC and FA.