ROLE OF IMMUNOHISTOCHEMISTRY IN THE DIAGNOSIS OF PAPILLARY CARCINOMA THYROID
Introduction Papillary thyroid carcinoma is the most common thyroid neoplasm.Histopathological diagnosis is the gold standard and the diagnosis is based on the characteristic nuclear features. Focal presence of nuclear features in certain benign lesions and absence of papillary architecture in the variants of papillary carcinoma leads to diagnostic difficulties. The aim of this study is to assess the expression of Immunohistochemical markers in the variants of papillary thyroid carcinoma.Materials and Method : 30 cases of papillary thyroid carcinoma diagnosed in our institution were selected . Histo-morphological features were analysed and Immunostaining with Cytokeratin 19, HBME 1 and Ki 67 was done in the representative blocks. The results of Cytokeratin 19 and HBME 1were analysed based on the semi-quantitative scoring. Ki 67 results were analysed based on the labeling index.Results All the cases (100%) showed positivity for Cytokeratin 19 and 93.3% cases showed positivity for HBME 1. In 31.8% cases, the surrounding non neoplastic thyroid tissue also showed positivity for Cytokeratin 19 but it was focal and weak. Ki 67 labeling index of diffuse sclerosing and columnar cell variants was compared with that of the classical variant. The two variants showed higher labeling index compared to the classical variant. Conclusion Immunohistochemistry aids in improving the diagnostic accuracy and assessment of prognosis of the variants.Use of a panel of markers is helpful because the sensitivity and specificity of different markers varies and no single marker is highly sensitive or specific for the diagnosis of papillary carcinoma thyroid.
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