الفهرس 
TitleOnly 14 pages are availabe for public view
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Abstract
Classic nuclear features such as elongated nuclei, inconspicuous eccentric nucleoli, crinkled nuclear membranes, chromatin clearing, and intra-nuclear grooves are used to diagnose papillary thyroid cancer. Although the majority of PTC can be diagnosed using histopathologic criteria, there are a few situations when benign thyroid tissue or lesions might resemble nuclear cytologic characteristics or the architecture and growth pattern of PTC, creating diagnostic challenges. Thus we are in need of a new tool or marker with especially high sensitivity and specificity in attempt to solve these challenging cases.
Trop-2 is a cell-surface glycoprotein overexpressed by a variety of epithelial carcinomas with reported low to restricted expression in normal tissues. Expression of Trop-2 has been associated with increased tumor aggressiveness, metastasis and decreased patient survival. The HBME-1 monoclonal antibody was developed against a biochemically unknown epitope detected in the membrane of mesothelial cells, lining their microvillous surface in a thick membrane pattern. HBME-1 is a multifunctional immunohistochemical marker in surgical pathology that displays reactivity in a wide variety of epithelial and mesenchymal tumours. Galectin-3 is a β-galactoside -binding protein that is expressed by a range of human cell types. Galectin-3 has been identified as a biomarker with associations to inflammation, fibrosis, and overall mortality risk in the general population. Galectin-3 impacts oncogenesis and development via a number of mechanisms. Elevated Galectin-3 expression has been related to a variety of malignancies as well as neoplastic progression, and it has the potential to be a valuable prognostic and diagnostic biomarker in oncology.
The aim of the present work is to study the Immunohistochemical Expression of TROP-2 in Papillary Thyroid Carcinoma and Different Benign Thyroid Lesions and Comparison with HBME -1 and Galectin-3 Expression.
The present study included 105 thyroid gland paraffin embedded tissue specimens that were divided into four groups according to their H&E diagnoses into 45 cases of Pca classic, 20 FVPCA cases, 20 FA cases and 20 NG cases.
In the current work, Trop-2 stained 40 out of 45 Pca classic cases (89 %) and 11 out of 20 FVPCA cases (55 %) with varying percentages and intensities. All 20 FA cases ( 100 %) as well as all 20 NG cases ( 100 %) were negative with the Trop-2. HBME-1 stained all 45 Pca classic cases ( 100 %) and 18 out of 20 FVPCA cases (90 %), while all 20 FA cases (100%) and 18 out of 20 ( 90%) NG were negative. Galectin-3 stained all 45 cases of Pca classic (100 %) and 18 out of 20 FVPCA cases ( 90 %). Out of 20 FA cases, 18 cases were negative (90 %) and 2 cases were positive ( 10 %), while all 20 NG cases (100 %) were negative.
Trop-2 antibody had a sensitivity of 78 %, 55 % and 89 % when used to compare between PTC lesions combined (Pca classic + FVPCA), FVPCA cases only and Pca classic cases only respectively from benign lesions. These results were statistically significant (p value <0.001). The Trop-2 antibody had a specificity of 100 % when used to differentiate between PTC lesions combined, FVPCA cases only and Pca classic cases only respectively from benign lesions. These results were statistically significant (P value < 0.001).
Summary, Conclusions & Recommendations
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The HBME-1 antibody had a sensitivity of 97 %, 90 % and 100 % in differentiating between the PTC lesions combined, FVPCA cases only and Pca classic cases only respectively from benign lesions. These results were statistically significant (p value <0.001). The HBME-1 antibody had a specificity of 95 % in differentiating between the PTC lesions combined, FVPCA cases only and Pca classic cases only respectively from benign lesions. These results were statistically significant (P value < 0.001).
The Galectin-3 antibody had a sensitivity of 96.9 %, 90 % and 100 % in differentiating between the PTC lesions combined, FVPCA cases only, and Pca classic cases only respectively from benign lesions. These results were statistically significant (p value <0.001). The Galectin-3 antibody had a specificity 95 % when used to differentiate between PTC lesions combined, FVPCA cases only and Pca classic cases only respectively from benign lesions. These results were statistically significant (P value < 0.001).
Regarding antibody combinations, the use of the triple combination Trop-2 + HBME-1 + Galectin-3 was most sensitive (100%) while the use of the triple combination, as well as the combination between both Trop-2 + Galectin-3 and HBME-1 + Galectin-3 were the most specific (100 %) in differentiating between malignant lesions combined from benign lesions.
When differentiating between FVPCA cases only from benign lesions, the triple combination as well as the combination between Trop-2 + Galectin-3 were most sensitive (100 %). Regarding specificity, the triple combination was the most specific (100 %).
When differentiating between Pca classic cases only from benign lesions, the tripple combination as well as the combination between Trop-2 + Galectin-3 and HBME-1 + Galectin-3 were the most sensitive (100 %) and most specific ( 100 %).