ACCURACY AND DIAGNOSTIC UTILITY OF FROZEN SECTION IN THYROID LESIONS: A COMPARATIVE STUDY

Imprint cytology can provide a useful adjunct to the frozen section diagnosis and may be used safely in the intraoperative diagnosis of thyroid nodules, especially in the centres where frozen section facilities are not available. This study was conducted to compare imprint cytology and frozen section in terms of diagnostic accuracy, sensitivity, specificity, positive predictive value and to assess the value of imprint cytology in the intraoperative diagnosis of thyroid lesions. A total of 57 consecutive patients were enrolled in the study. All of the patients underwent frozen section in the department of pathology, BSMMU, Dhaka. Imprints were taken from the fresh specimen sent for frozen section from departments of otolaryngology and surgery of BSMMU. Imprint slides were stained with rapid H & E staining method. Then the tissues were submitted for frozen section by standard method. In this study, diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of imprint cytology were 81.25%, 66.66%, 82.59%, 87.12% respectively. Frozen section revealed the diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive as 88.46%, 72.72%, 100%, 100%, 83.33% respectively. Imprint cytology was found to be comparable with frozen section in diagnostic accuracy and sensitivity. Since imprint cytology is a simple and cost-effective procedure it can be used as an alternative to frozen section in hospitals where frozen section facilities are not available. Key Words: Imprint cytology, frozen section, intraoperative diagnosis of thyroid lesions doi: 10.3329/bjpath.v24i1.2876 Bangladesh J Pathol 24 (1) : 12-15

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The Potential Diagnostic Utility of TROP-2 & C-Kit in Thyroid Neoplasms

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i1731035 ◽

2021 ◽

pp. 110-123

Author(s):

Amal Abd El-Halim El-Dakrany ◽

Yomna Abd El-Monem Zamzam ◽

Rania Elsayed Wasfy ◽

Assia Mahfouz Abd El-Raouf

Keyword(s):

Diagnostic Tool ◽

Follicular Adenoma ◽

Follicular Carcinoma ◽

Thyroid Neoplasms ◽

Common Finding ◽

Diagnostic Utility ◽

Large Set ◽

Benign Thyroid ◽

Nuclear Features ◽

Thyroid Lesions

Background: Thyroid nodules are common finding, only 5% of nodules are malignant and the vast majority is non-neoplastic lesions or benign neoplasms. Thyroid cancer incidence is increasing faster than any other cancer types, thus representing one of the most common and clinically worrying malignant tumors of the endocrine system. Trophoblast antigen 2 (TROP2) is a transmembrane receptor glycoprotein encoded by the tumor-associated calcium signal transducer 2(Tacstd2) gene, which is located on chromosome 1p32. Although the biological function of TROP2 is unclear, accumulating evidence has demonstrated that its expression is elevated in various malignant tissues, whereas in human normal tissues relatively low or no TROP2 expression is observed. C-Kit is a type III receptor tyrosine kinase. C-Kit expression and signaling have been well characterized in several tumors, including gastrointestinal stromal tumors (GISTs). However, few studies have investigated c-Kit in the thyroid gland or in thyroid malignancies. The aim of this study was to investigate the diagnostic utility of TROP-2 on a large set of neoplastic thyroid lesions & to investigate the utility of TROP-2 & c-Kit markers to distinguish between benign and malignant thyroid neoplasms on Paraffin blocks. Methods: Immunohistochemistry for TROP2 and c-Kit was carried out on 85 different thyroid lesions (40 benign, 7 borderline and 38 malignant). Results: Malignant thyroid lesions were found to have negative expression of c-Kit in contrast to 80% of benign thyroid neoplasms. TROP2 was strong positive in 87.5% of papillary thyroid carcinomas (PTC), but there was no TROP2 expression in benign thyroid neoplasms, non-invasive follicular thyroid neoplasm with papillary like nuclear features, follicular carcinoma, anaplastic and poorly differentiated thyroid carcinoma. Conclusions: TROP2 is a good diagnostic tool for PTCs to differentiate between PTCs & other lesions with papillary like nuclear features as NIFTP, c-Kit is a good diagnostic tool for follicular adenoma & to differentiate between follicular adenoma & follicular carcinoma.

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