Expressions of CK-19, NF-kB, E-Cadherin, b-Catenin and EGFR as diagnostic and prognostic markers by immunohistochemical analysis in thyroid carcinoma
Kruttibas Sethi, Siddik Sarkar, Subhasis Das, Shashi Rajput, Abhijit Mazumder, Bhaskar Roy, Susmita Patra, Biswanarayan Mohanty, Adel K. El-Naggar and Mahitosh Mandal
Immunohistochemical markers have been proposed for thyroid cancer diagnosis and prognostic studies. Immunohistochemical analysis of CK-19, NF-κB, β-catenin, E-cadherin and EGFR were done to evaluate their diagnostic and prognostic efficiencies in eighty eight cancer specimen (PTC-52, FTC-16, benign nodule- 12 and MNG-8). CK-19 was positive in 91% (62/68) DTC, 98% (51/52) PTC, 69% (11/16) FTC and 15% (3/20) benign thyroid nodules. NF-κB was expressed 93% (63/68) DTC, in 96% (50/52) PTC, 81% (11/16) FTC and 15% (3/20) benign thyroid nodules. Both CK- 19 and NF-κB were significantly differentiated DTC, PTC and FTC from benign thyroid nodule (p<0.0001) with diagnostic accuracy of 89.74%, 94.4% and 77.4% for CK-19 and 91.0%, 90.5% and 83.5% respectively for NF-κB. Though CK-19 and NF-κB were equally sensitive but CK-19 was most specific in the diagnosis of DTC and PTC. The diagnostic accuracy of β-catenin was 96% and 94% and accuracy of E-cadherin was 90.1% and 93.9% for the diagnosis of metastatic PTC and FTC respectively. EGFR showed 90% (18/20) of metastatic PTC (p<0.0001) and sensitivity, specificity and accuracy were 90%, 71.8% and 78.85% respectively. CK-19 and NF-κB were accurately diagnosed in DTC, PTC and FTC whereas, NF-κB, E-cadherin, β-catenin and EGFR were strongly expressed in invasive papillary thyroid cancers and FTC, thus can be important diagnostic and prognostic marker for FTC and metastatic PTC. This may be concluded that immunohistochemical expression of panel of markers CK-19, NF-κB, E-cadherin, β-catenin and EGFR can be useful in diagnosis and prognosis of DTC.
Keywords: Differentiated thyroid carcinoma (DTC), Papillary thyroid carcinoma (PTC), Follicular thyroid carcinoma (FTC), Cytokeratin-19 (CK-19), Nuclear factor-kappa B (NF-κB), β-catenin, E-cadherin