Thyroid peroxidase immunohistochemistry in differential diagnosis of thyroid tumors

Thyroperoxidase (TPO) is a thyroid-specific enzyme expressed by differentiated thyroid cells. Initial immunohistochemical studies claimed that TPO expression, detected by the monoclonal antibody mAb 47, may be a potentially important diagnostic tool in differentiating malignant from benign lesions....

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Bibliographic Details
Published in:Endocrine pathology 2006, Vol.17 (1), p.53-60
Main Authors: Savin, Svetlana, Cvejic, Dubravka, Isic, Tijana, Petrovic, Ivana, Paunovic, Ivan, Tatic, Svetislav, Havelka, Marija
Format: Article
Language:English
Subjects:
Adenoma - enzymology
Adenoma - pathology
Biomarkers, Tumor - metabolism
Cancer
Carcinoma - enzymology
Carcinoma - pathology
Diagnosis, Differential
Immunoenzyme Techniques
Iodide Peroxidase - metabolism
Retrospective Studies
Sensitivity and Specificity
Thyroid Diseases - diagnosis
Thyroid Diseases - enzymology
Thyroid gland
Thyroid Neoplasms - enzymology
Thyroid Neoplasms - pathology
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Summary:Thyroperoxidase (TPO) is a thyroid-specific enzyme expressed by differentiated thyroid cells. Initial immunohistochemical studies claimed that TPO expression, detected by the monoclonal antibody mAb 47, may be a potentially important diagnostic tool in differentiating malignant from benign lesions. However, some recent studies have failed to reproduce the earlier results, suggesting the limitations for TPO immunohistochemistry. To assess these observations we have evaluated the immunohistochemical expression of TPO in thyroid tissue from 215 patients. The studied material included 87 nonmalignant thyroid lesions and 128 thyroid carcinomas. TPO expression was investigated using newly available mAb 47 and staining of less than 80% of the follicular cells/specimen as the threshold indicating a malignant lesion. We found that TPO had a sensitivity of 89.9% for cancer and a specificity of 64.4% for nonmalignant lesions, showing that it does not give a sufficient degree of diagnostic certainty that the lesion is benign. In addition, the variability in the degree of TPO expression found within and between follicular carcinomas, and the significant number of benign adenomas having similar immunostaining patterns, assured us that TPO immunostaining is not sufficiently discriminatory in the differential diagnosis of thyroid cancer versus benign lesions.
ISSN:1046-3976
1046-3976
1559-0097
DOI:10.1385/EP:17:1:53