ECE2023 Poster Presentations Thyroid (163 abstracts)
A retrospective study on the immunocitochemistry profile of benign thyroid nodules unresponsive to thermal ablation
Stella Bernardi 1 , Silvia Taccogna 2 , Martina D’Angelo 2 , Fabiola Giudici 3 , Giovanni Mauri 4 , Bruno Raggiunti 5 , doris tina 5 , Fabrizio Zanconati 1 , Enrico Papini 6 & Roberto Negro 7
1University of Trieste, Department of Medical Surgical and Health Sciences, Trieste, Italy; 2Regina Apostolorum, Pathology Unit, Albano Laziale, Italy; 3Gustave Roussy, Bureau Biostatistique et Epidémiologie, Villejuif, France; 4European Institute of Oncology, Italy; 5ASL - Distretto di Atri, Atri, Italy; 6Regina Apostolorum, Endocrinology Department, Italy; 7Ospedale ‘Vito Fazzi’, Endocrinology Unit, Lecce, Italy
Objective: Thermal ablations (TA) are gaining ground as alternative options to conventional therapies for symptomatic benign thyroid nodules. Little is known on the impact of nodule biology on the outcomes of TA. The aim of our study was evaluating the baseline immunocytochemistry profile of thyroid nodules that are poorly responsive to TA, in order to identify potential predictors of treatment response.
Methods: we retrospectively selected by propensity score matching two groups of patients with benign thyroid nodules treated with TA, namely CASE (patients who did not respond to TA and were later surgically treated) and CNT (patient who responded to TA). The fine-needle aspiration cytology (FNAC) slides obtained before TA were stained for Galectin-3, HBME-1, CK-19, and Ki67.
Results: In both groups, patients were predominantly females in their mid 40s, their nodules measured 17 mL (range 10-55) and were mostly solid (that is with a solid component > 90%) and non-functioning. Treatment modality was most often laser ablation (87-92% of cases). There were no differences in terms of energy delivered. Benign nodules of the CASE group (n=24), did not express CK-19 while expressed more frequently Ki-67 as compared to the CNT group (n=26). CK-19 appeared to be the most sensitive marker (high NPV), whereas Ki-67 was the most specific (high PPV) for retreatment and regrowth. When we combined CK-19 and Ki-67, the AUC was of 0.69 (0.57-0.81) for retreatment, and it had a sensitivity, specificity, PPV and NPV of 32%, 91%, 78%, and 58%.
Conclusions: CK-19 expression was predictive of no regrowth/retreatment. If confirmed, this finding could provide a rapid and inexpensive information about the potential outcome of TA on benign thyroid nodules. As CK-19 is more frequently expressed in adenomatous hyperplasia, it could be speculated that these nodules, rather than follicular adenomas, are better candidates for TA.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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