The Significance Of Syndecan-1, Galectin-3, CK19, P63and CD56in Diagnosis And Differential Diagnosis Of Thyroid Papillary Lesions

Objective：To evaluate the expression of Syndecan-1, Galectin-3, CK19, p63and CD56indifferential diagnosis of papillary thyroid lesions such as papillary thyroid carcinoma(PTC), papillary thyroid hyperplasia (PTH) and PTH with atypical morphologicalfeatures (PTH-A).Methods：A total of108cases of papillary thyroid carcinoma(PTC),35cases of papillary thyroidhyperplasia (PTH) and34cases of PTH with atypical morphological features (PTH-A)were selected. Their expression was studied immunihistochemically.Results：1. Syndecan-1was positive in81PTCs(75.0%,81/109),2PTH-As(5.9%,2/34) and1PTH(2.9%,1/35). The positivity rate of Galectin-3was96.30%(104/108) in PTC,5.9%(2/34) in PTH-A and22.9%(8/35) in PTH group respectively. CK19was positive in106PTC cases (98.1%,106/108),14PTH-A cases (41.2%,14/34) and12PTH cases(34.3%,12/35). The positivity rate of p63was42.6%(46/108) in PTC,29.4%(10/34) inPTH-A and14.3%(5/35) in PTH group respectively; CD56was positive in40PTCcases (37.0%,40/108),12PTH-A cases (70.6%,24/34), and31PTH cases (88.6%,31/35). Syndecan-1, Galectin-3and CK19showed significantly higher expression inPTC than in PTH or PTH-A (p<0.05); p63was significantly higher in PTC than inPTH(p<0.05), but there was no statistically significant difference (p>0.05) for theexpression of p63marker between PTC and PTH-A; CD56showed significantly lowerexpression in PTC than in PTH or PTH-A (p<0.05); There was no statisticallysignificant difference (p>0.05) for the expression of each marker between PTH-A andPTH. 2. The comparison of sensitivity: CK19>Galectin-3>Syndecan-1>CD56>p63;specificity: Syndecan-1>CD56>p63>Galectin-3>CK19. Co-expression of either two orthree of the five markers could greatly improve the specificity to88.6%-100%and thesensitivity to75.0%-100%.3. No significant relationship were found between the expression of Syndecan-1, CK19,p63and CD56and clinicalpathological features such as age, gender, tumor size,multifocality, lymph node metastasis and stage. Galectin-3was associated with lymphnode metastasis(p=0.0292) and greater tumor stage(p=0.0426).Conclusions：1. Syndecan-1was the most specific maker among the five, then was CD56. In terms ofsensitivity, CK19and Galectin-3were better than others. Each of these markers had itsimportant meaning in the diagnosis of papillary lesions, but no one was perfect. Theutilization of two or three of the five is helpful in the distinction of the papillary thyroidlesions.2. Galectin-3was associated with lymph node metastasis(p=0.0292) and greater tumorstage(p=0.0426), indicating the different role in.the different stage of PTC.