Background. The diagnosis of follicular lesions is a grey zone in thyroid fine-needle aspiration (FNA) cytology. Our study aims to verify if staining with Emerin is a helpful marker of the follicular variant of papillary thyroid carcinoma (FVPTC) in the differential diagnosis of follicular-patterned lesions. Methods. We designed both a prospective study on smears and Thin Prep specimens to prove the feasibility of the procedure and a retrospective study on 78 FNA cell-blocks from cases which, after surgery, turned out to be either benign (34 cases) or malignant lesions (44, of which 31 PTC). From each sample, we obtained two slides, one stained with Hematoxylin and Eosin (H&E) and the other with immunohistochemistry (IHC) for Emerin. In Thy3 cases, HBME-1 and Gal 3 stains were also done. Two observers gave a judgement in Thy categories (British Thyroid Association) on H&E, Emerin, HBME-1 and Gal 3 stained slides. Results. The prospective study demonstrated that Emerin staining is an effective tool for nuclear membrane decoration and amplification of nuclear irregularities. In the retrospective study, inter-observer agreement proved higher in Emerin-stained slides (K of Cohen-Fleiss = 0.6890) than H&E-stained slides (K of Cohen-Fleiss = 0.4878). Sensitivity and overall accuracy were higher for Emerin (respectively, 77.27% and 84.61%) than H&Estained slides (respectively, 36.36% and 62.82%). Emerin staining proved able to identify all cases of PTC, including all cases of FVPTC. In Thy3 cases, Emerin’s sensitivity and specificity (64% and 96%) proved higher than HBME-1’s (60% and 88%), and Gal3’s (61% and 68%). Conclusions. Emerin stain, is a useful tool in the cytological diagnosis of thyroid lesions. It enhances detection of nuclear irregularities typical of PTC, thus helping to solve inconclusive FNA cases, mainly in those cases of FVPTC with a reduced expression of nuclear irregularities in the traditional stains (H&E).
Asioli S., Maletta F., Pacchioni D., Lupo R., Bussolati G. (2010). Nuclear membrane decoration by emerin staining improves cytological detection of papillary thyroid carcinomas.
Nuclear membrane decoration by emerin staining improves cytological detection of papillary thyroid carcinomas
ASIOLI, SOFIA;
2010
Abstract
Background. The diagnosis of follicular lesions is a grey zone in thyroid fine-needle aspiration (FNA) cytology. Our study aims to verify if staining with Emerin is a helpful marker of the follicular variant of papillary thyroid carcinoma (FVPTC) in the differential diagnosis of follicular-patterned lesions. Methods. We designed both a prospective study on smears and Thin Prep specimens to prove the feasibility of the procedure and a retrospective study on 78 FNA cell-blocks from cases which, after surgery, turned out to be either benign (34 cases) or malignant lesions (44, of which 31 PTC). From each sample, we obtained two slides, one stained with Hematoxylin and Eosin (H&E) and the other with immunohistochemistry (IHC) for Emerin. In Thy3 cases, HBME-1 and Gal 3 stains were also done. Two observers gave a judgement in Thy categories (British Thyroid Association) on H&E, Emerin, HBME-1 and Gal 3 stained slides. Results. The prospective study demonstrated that Emerin staining is an effective tool for nuclear membrane decoration and amplification of nuclear irregularities. In the retrospective study, inter-observer agreement proved higher in Emerin-stained slides (K of Cohen-Fleiss = 0.6890) than H&E-stained slides (K of Cohen-Fleiss = 0.4878). Sensitivity and overall accuracy were higher for Emerin (respectively, 77.27% and 84.61%) than H&Estained slides (respectively, 36.36% and 62.82%). Emerin staining proved able to identify all cases of PTC, including all cases of FVPTC. In Thy3 cases, Emerin’s sensitivity and specificity (64% and 96%) proved higher than HBME-1’s (60% and 88%), and Gal3’s (61% and 68%). Conclusions. Emerin stain, is a useful tool in the cytological diagnosis of thyroid lesions. It enhances detection of nuclear irregularities typical of PTC, thus helping to solve inconclusive FNA cases, mainly in those cases of FVPTC with a reduced expression of nuclear irregularities in the traditional stains (H&E).I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
