수술 전 세침흡입 세포검사에서 악성감별이 어려운 갑상선 결절에 대한 Galectin-3 면역조직화학 염색의 진단적 유용성
Diagnostic Feasibility of Galectin-3 for Suspicious Malignant Thyroid Nodule in Preoperative Fine-Needle Aspiration Cytology
엄태익, 최진욱, 민수기, 이명훈, 박철영, 박성우, 이봉화, 김이수,
소속 상세정보
엄태익 ( Eum Tae-Ik )
한림대학교 의과대학 외과학교실
최진욱 ( Choi Jin-Wook )
한림대학교 의과대학 외과학교실
민수기 ( Min Soo-Kee )
한림대학교 의과대학 병리학교실
이명훈 ( Lee Myung-Hoon )
한림대학교 의과대학 진단방사선과학교실
박철영 ( Park Cheol-Young )
한림대학교 의과대학 내과학교실
박성우 ( Park Sung-Woo )
한림대학교 의과대학 내과학교실
이봉화 ( Lee Bong-Wha )
한림대학교 의과대학 외과학교실
김이수 ( Kim Lee-Su )
한림대학교 의과대학 외과학교실
KMID : 0371320040660060462
Abstract
Purpose: Fine Needle Aspiration Cytology (FNAC) is considered as the most feasible preoperative diagnostic tool for thyroid lesions. However, the false results of FNAC are not uncommon, and so we need a development of novel supportive preoperative diagnostic modality. In previous studies, galectin-3, a β-galactosidase-binding protein, was expressed preferentially in thyroid malignancies. In this study, we analyzed whether the galectin-3 immunohistochemistry (IHC) is useful as a preoperative diagnostic tool.
Methods: 79 patients who underwent a definite surgery for thyroid nodule were analyzed. The preoperative routine stained cytology and galectin-3 IHC for fine-needle aspirates and the galectin-3 IHC for postoperative specimen were performes. Individual results were compared with the final diagnoses.
Results: Of 79 specimens, 28 (35.4%) were malignant. The false negative rate (FNR) of galectin-3 IHC in the surgical specimen was 10.0%. The FNR of galectin-3 IHC for the fine-needle aspirates was 50.0% and the FNR of routine cytology was 20.5%. However, the FNR of galectin-3 IHC in the fine-needle aspirates was lowered up to 20.0% in thyroid lesions obtained by using ultrasound-guided aspiration. Among the 14 cases reported as suspicious in routine cytology, 13 cases were revealed the accurate correlations in galecin-3 IHC.
Conclusion: It appears that galectin-3 IHC in preoperative FNAC alone had a little accuracy. However, preoperative galectin-3 IHC in thyroid lesions obtained under the ultrasound guidance could be diagnostic. Especially in suspicious group in FNAC, galectin-3 IHC could be critical method in differentiating malignant lesions from benign lesions of thyroid.
키워드
갑상선암;Galectin-3 면역조직화학염색;세침흡입세포감사;Thyroid carcinoma;Galectin-3 immunohistochemistry;Fine needle aspiration cytology
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