Journal of Endocrinological Investigation

, Volume 33, Issue 6, pp 378–381 | Cite as

The diagnostic accuracy of the immunochemical markers in the pre-operative evaluation of follicular thyroid lesions

  • E. Raggio
  • M. Camandona
  • D. Solerio
  • P. Martino
  • A. Franchello
  • F. Orlandi
  • G. Gasparri
Original Article


Aim of the study was to consider the diagnostic accuracy of galectine-3 (GAL3) in the pre-operative cytological evaluation of follicular lesions. Materials and methods: We retrospectively evaluated 100 patients suffering from thyroid nodular disease submitted to thyroidectomy from 2006 to 2007 in our Institution. Before surgery all patients underwent fine needle aspiration biopsy. The immunocytochemical analysis was performed on fine needle aspiration specimens using species-specific monoclonal antibodies and a biotin-free detection system. Based on preoperative cytological reports, 40 patients had pre-operative malignant results, and 60 patients (46 females and 14 males) showed follicular lesions. The sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of GAL3 was evaluated. Statistical analysis: Chisquare test was used to compare frequencies of GAL3 expression between the different hystopathological groups. Results: GAL3 proved to have 55% sensitivity, 100% specificity, 70% negative predictive value, and 78% diagnostic accuracy. The GAL3 expression in neoplastic and benign lesions was significantly different (GAL3+ in 16 out of 29 neoplastic lesions, GAL3+ 0 out of 31 benign lesions, p<0.01). Even comparing the GAL3 positivity between the follicular adenomas (0 GAL3+ out of 20) and the group of follicular carcinomas (5 GAL3+ out of 6), we found a statistically significant difference (p<0.01). Conclusions: Based on the data from our experience, the patients with a cytological diagnosis of GAL3 positive follicular neoformation should be referred for surgery without any further immunocytological testing.


CK19 follicular thyroid lesion GAL3 HBME-1 


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  1. 1.
    Mazzaferri EL. Management of a solitary thyroid nodule. N Engl J Med 1993, 328: 553–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Hegedüs L. Clinical practice. The thyroid nodule. N Engl J Med 2004, 351: 1764–71.PubMedCrossRefGoogle Scholar
  3. 3.
    Gharib H. Fine-needle aspiration biopsy of thyroid nodules: advantages, limitations, and effects. Mayo Clinic Proc 1994, 69: 44–9.CrossRefGoogle Scholar
  4. 4.
    Burch HB. Evaluation and management of the solid thyroid nodule. Endocrinol Metab Clin North Am 1995, 24: 663–710.PubMedGoogle Scholar
  5. 5.
    Cochand-Priollet B, Guillausseau PJ, Chagnon S, et al. The diagnostic value of fine-needle aspiration biopsy under ultrasonography in nonfunctional thyroid nodules: a prospective study comparing cytologic and histologic findings. Am J Med 1994, 97: 152–7.PubMedCrossRefGoogle Scholar
  6. 6.
    Baloch ZW, Fleisher S, LiVolsi VA, Gupta PK. Diagnosis of “follicular neoplasm”: a gray zone in thyroid fine-needle aspiration citology. Diagn Cytopathol 2002, 26: 41–4.PubMedCrossRefGoogle Scholar
  7. 7.
    Lin JD, Hsueh C, Chao TC, et al. Thyroid follicular neoplasms diagnosed by high-resolution ultrasonography with fine-needle aspiration cytology. Acta Cytol 1997, 41: 687–91.PubMedCrossRefGoogle Scholar
  8. 8.
    Liou MJ, Chan EC; Lin JD, Liu FH, Chao TC. Human telomerase reverse transcriptase (hTERT) gene expression in FNA samples from thyroid neoplasms. Cancer Lett 2003, 191: 223–7.PubMedCrossRefGoogle Scholar
  9. 9.
    Czyz W, Balcerczak E, Jakubiak M, Pasieka Z, Kuzdak K, Mirowski M. HMGI(Y) gene expression as potenyial marker of thyroid follicular carcinoma. Langenbecks Arch Surg 2004, 389: 193–97.PubMedCrossRefGoogle Scholar
  10. 10.
    van Hoeven KH, Kovatich AJ, Miettinen M. Immunocytochemical evaluation of HBME-1, CA 19-9 and CD-15 (Leu-M1) in fine-needle aspirates of thyroid nodules. Diagn Cytopathol 1998, 18: 93–7.PubMedCrossRefGoogle Scholar
  11. 11.
    Prasad ML, Pellegata NS, Huang Y, Nagaraja HN, Chapelle A, Kloos RT. Galectin-3, fibronectin-1, CITED-1, HBME1 and cytok-eratin-19 immunohistochemistry is useful for the differential diagnosis of thyroid tumors. Mod Pathol 2005, 18: 48–57.PubMedCrossRefGoogle Scholar
  12. 12.
    Henry JF, Denizot A, Porcelli A, et al. Thyroperoxidase immunodetection for the diagnosis of malignancy on fine-needle aspiration of thyroid nodules. World J Surg 1994, 18: 529–34.PubMedCrossRefGoogle Scholar
  13. 13.
    Khurana KK, Truong LD, LiVolsi VA, Baloch ZW. Cytokeratin 19 im-munolocalization in cell block preparation of thyroid aspirates. An adjunct to fine-needle aspiration diagnosis of papillary thyroid carcinoma. Arch Pathol Lab Med 2003, 127: 579–83.PubMedGoogle Scholar
  14. 14.
    Bartolazzi A, Gasbarri A, Papotti M, et al. Application of an immunodiagnostic method for improving preoperative diagnosis of nodular thyroid lesions. Lancet 2001, 357: 1644–50.PubMedCrossRefGoogle Scholar
  15. 15.
    Lloyd RV. Distinguishing benign from malignant thyroid lesions: galectin 3 as the latest candidate. Endocr Pathol 2001, 12: 255–7.PubMedCrossRefGoogle Scholar
  16. 16.
    Xu XC, El-Naggar AK, Lotan R. Differential expression of galectin-1 and galectin-3 in thyroid tumors. Potential diagnostic implications. Am J Pathol 1995, 147: 815–22.PubMedCentralPubMedGoogle Scholar
  17. 17.
    Fernández PL, Merino MJ, Gómez M, et al. Galectin-3 and laminin expression in neoplastic and non-neoplastic thyroid tissue. J Pathol 1997, 181: 80–6.PubMedCrossRefGoogle Scholar
  18. 18.
    Bartolazzi A, Papotti M, Orlandi F. Methodological considerations regarding the use of galectin-3 expression analysis in preoperative evaluation of thyroid nodules. J Clin Endocrinol Metab 2003, 88: 950–1.PubMedCrossRefGoogle Scholar
  19. 19.
    Sahoo S, Hoda SA, Rosai J, DeLellis RA. Cytokeratin 19 immunoraectivity in the diagnosis of papillary thyroid carcinoma: a note of caution. Am J Clin Pathol 2001, 116: 696–702.PubMedCrossRefGoogle Scholar
  20. 20.
    Saggiorato E, De Pompa R, Volante M, et al. Characterization of thyroid “follicular neoplasms” in fine-needle aspiration cytological specimens using a panel of immunohistochemical markers: a proposal for clinical application. Endocr Relat Cancer 2005, 12: 305–17.PubMedCrossRefGoogle Scholar

Copyright information

© Italian Society of Endocrinology (SIE) 2010

Authors and Affiliations

  • E. Raggio
    • 1
  • M. Camandona
    • 1
  • D. Solerio
    • 1
  • P. Martino
    • 1
  • A. Franchello
    • 1
  • F. Orlandi
    • 2
  • G. Gasparri
    • 1
  1. 1.Esophageal Surgery, General surgery 3University of TurinTurinItaly
  2. 2.Section of Endocrinology, Department of Biological SciencesUniversity of TurinTurinItaly

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