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Collegium antropologicum, Vol. 34 No. 1, 2010.

Original scientific paper

Accuracy of Fine Needle Aspiration Biopsy with and without the Use of Tumor Markers in Cytologically Indeterminate Thyroid Lesions

Neven Mateša ; Department of Oncology and Nuclear Medicine, University Hospital »Sestre milosrdnice«, Zagreb, Croatia
Ivan Šamija ; Department of Oncology and Nuclear Medicine, University Hospital »Sestre milosrdnice«, Zagreb, Croatia
Zvonko Kusić ; University of Zagreb, School of Medicine, Zagreb, Croatia

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Abstract

We investigated if the use of two tumor markers, galectin-3 and CD44v6, could improve diagnostic accuracy of thyroid fine needle aspiration biopsy (FNAB) in cytologically indeterminate lesions (CIL). 351 patients with CIL [cellular follicular lesion/suspicious follicular neoplasm/suspicious Hürthle cell neoplasm (CFL/sFN/sHCN), Hürthle cell neoplasm (HCN), and follicular neoplasm (FN)] and surgical follow-up were investigated. 251 patients had FNAB diagnoses made without help of tumor markers and the rest of 100 patients had FNAB diagnoses made with a known expression of tumor markers determined by the reverse transcription (RT)-PCR. Risk of malignancy in all 351 patients with CIL was 6.8%. In the group with FNAB made without RT-PCR, there were 140 CFL/sFN/sHCN with the risk of malignancy of 4.2%, 92 FN with the risk of malignancy of 13.0%, and 19 HCN with the risk of malignancy of 5.2%. In the group with FNAB made with RT-PCR, there were 49 CFL/sFN/sHCN with the risk of malignancy of 2.0%, 40 FN with the risk of malignancy of 7.5%, and 11 HCN with the risk of malignancy of 9.0%. In the group with at least one positive tumor marker (N=69), the risk of malignancy was 3.1% for CFL/sFN/sHCN, 11.1% for FN, and 10.0% for HCN. In the group with negative tumor markers (N=31) there were no malignancies. The use of tumor markers, galectin-3 and CD44v6, determined by RT-PCR improves only sensitivity of thyroid FNAB in CIL. In most patients with CIL, and negative both tumor markers, conservative approach is advisable.

Keywords

thyroid disease; galectin-3; CD44v6 antigen; reverse transcriptase-polymerase reaction; biopsy; fine needle aspiration cytology

Hrčak ID:

51241

URI

https://hrcak.srce.hr/51241

Publication date:

10.3.2010.

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