The Effects of Immunocytochemistry on Diagnostic Accuracy in Thyroid Fine Needle Aspiration Cytology: A Retrospective Study

Ali Mızrak; Cansu Benli Işık; Esen Gül Uzuner; Saime Gül Barut

Article Details

The Effects of Immunocytochemistry on Diagnostic Accuracy in Thyroid Fine Needle Aspiration Cytology: A Retrospective Study

Authors:

Ali Mızrak | Cansu Benli Işık | Esen Gül Uzuner | Saime Gül Barut

Publisher:

Marmara University

Main Topics:

Pathology

Journal:

Clinical and Experimental Health Sciences Vol.15 Issue 3, pp.531-537

Document Type:

Article

Publication Date:

9/2025

Document Language:

English

Document ID (Org No.):

2001359598

pISSN:

2459-1459

Keywords:

Abstract:

 Objective: In thyroid cytology, ancillary studies are often utilized for intermediate-category cases to better differentiate between benign and malignant lesion. For this purpose, immunocytochemical markers may be preferred because they are cheaper than molecular studies and can be applied in many laboratories. This study retrospectively compares the diagnostic accuracy of cytology samples with and without immunocytochemistry and calculates the frequency of immunocytochemical marker use, as well as sensitivity and specificity rates. Methods: Between 2015 and 2023, 1816 samples from 1506 patients with a histological diagnosis after cytological examination thyroidectomy-lobectomy were included. Cases without a histological diagnosis were excluded. The Thin Prep method was used for all cytological sample preparations, and cell blocks were obtained. Demographic information, Bethesda system categories, immunocytochemical markers used, and histological diagnoses were recorded. Cases using at least one immunocytochemical marker were re-evaluated, and staining results were categorized as positive, focally positive, or negative. SPSS 15 software was used to assess data normality and perform statistical analyses. Results: The most frequently used markers were HBME-1 n167, CK 19 n106, Galectin-3 n75, and CD 56 n6. Sensitivity rates for HBME-1, CK 19, Galectin-3, and CD 56 were 91, 94, 76, and 75, respectively; specificity rates were 63, 61, 80, and 50, respectively. Comparing groups with and without immunocytochemistry, the risk of malignancy was: 6.95-6.97 for Bethesda category II; 21.7-19.0 for Bethesda category III; 76.0-37.1 for Bethesda category IV; 94.0-95.0 for category V; and 100 for category VI. Conclusion: In the follicular neoplasm group Bethesda category IV the risk of malignancy was higher in the immunohistochemistry applied group. No significant difference in malignancy risk was observed between groups with and without immunocytochemistry in other categories. Considering that immunocytochemical markers were predominantly applied in diagnostically challenging Bethesda categories, the similar malignancy risks across groups may suggest immunocytochemistry aids in accurate categorization. However, according to the results of this study, routine use of immunohistochemical markers in thyroid cytology is unnecessary except for Bethesda category IV.

 Objective: In thyroid cytology, ancillary studies are often utilized for intermediate-category cases to better differentiate between benign and malignant lesion. For this purpose, immunocytochemical markers may be preferred because they are cheaper than molecular studies and can be applied in many laboratories. This study retrospectively compares the diagnostic accuracy of cytology samples with and without immunocytochemistry and calculates the frequency of immunocytochemical marker use, as well as sensitivity and specificity rates. Methods: Between 2015 and 2023, 1816 samples from 1506 patients with a histological diagnosis after cytological examination thyroidectomy-lobectomy were included. Cases without a histological diagnosis were excluded. The Thin Prep method was used for all cytological sample preparations, and cell blocks were obtained. Demographic information, Bethesda system categories, immunocytochemical markers used, and histological diagnoses were recorded. Cases using at least one immunocytochemical marker were re-evaluated, and staining results were categorized as positive, focally positive, or negative. SPSS 15 software was used to assess data normality and perform statistical analyses. Results: The most frequently used markers were HBME-1 n167, CK 19 n106, Galectin-3 n75, and CD 56 n6. Sensitivity rates for HBME-1, CK 19, Galectin-3, and CD 56 were 91, 94, 76, and 75, respectively; specificity rates were 63, 61, 80, and 50, respectively. Comparing groups with and without immunocytochemistry, the risk of malignancy was: 6.95-6.97 for Bethesda category II; 21.7-19.0 for Bethesda category III; 76.0-37.1 for Bethesda category IV; 94.0-95.0 for category V; and 100 for category VI. Conclusion: In the follicular neoplasm group Bethesda category IV the risk of malignancy was higher in the immunohistochemistry applied group. No significant difference in malignancy risk was observed between groups with and without immunocytochemistry in other categories. Considering that immunocytochemical markers were predominantly applied in diagnostically challenging Bethesda categories, the similar malignancy risks across groups may suggest immunocytochemistry aids in accurate categorization. However, according to the results of this study, routine use of immunohistochemical markers in thyroid cytology is unnecessary except for Bethesda category IV.

 Objective: In thyroid cytology, ancillary studies are often utilized for intermediate-category cases to better differentiate between benign and malignant lesion. For this purpose, immunocytochemical markers may be preferred because they are cheaper than molecular studies and can be applied in many laboratories. This study retrospectively compares the diagnostic accuracy of cytology samples with and without immunocytochemistry and calculates the frequency of immunocytochemical marker use, as well as sensitivity and specificity rates. Methods: Between 2015 and 2023, 1816 samples from 1506 patients with a histological diagnosis after cytological examination thyroidectomy-lobectomy were included. Cases without a histological diagnosis were excluded. The Thin Prep method was used for all cytological sample preparations, and cell blocks were obtained. Demographic information, Bethesda system categories, immunocytochemical markers used, and histological diagnoses were recorded. Cases using at least one immunocytochemical marker were re-evaluated, and staining results were categorized as positive, focally positive, or negative. SPSS 15 software was used to assess data normality and perform statistical analyses. Results: The most frequently used markers were HBME-1 n167, CK 19 n106, Galectin-3 n75, and CD 56 n6. Sensitivity rates for HBME-1, CK 19, Galectin-3, and CD 56 were 91, 94, 76, and 75, respectively; specificity rates were 63, 61, 80, and 50, respectively. Comparing groups with and without immunocytochemistry, the risk of malignancy was: 6.95-6.97 for Bethesda category II; 21.7-19.0 for Bethesda category III; 76.0-37.1 for Bethesda category IV; 94.0-95.0 for category V; and 100 for category VI. Conclusion: In the follicular neoplasm group Bethesda category IV the risk of malignancy was higher in the immunohistochemistry applied group. No significant difference in malignancy risk was observed between groups with and without immunocytochemistry in other categories. Considering that immunocytochemical markers were predominantly applied in diagnostically challenging Bethesda categories, the similar malignancy risks across groups may suggest immunocytochemistry aids in accurate categorization. However, according to the results of this study, routine use of immunohistochemical markers in thyroid cytology is unnecessary except for Bethesda category IV.

 Objective: In thyroid cytology, ancillary studies are often utilized for intermediate-category cases to better differentiate between benign and malignant lesion. For this purpose, immunocytochemical markers may be preferred because they are cheaper than molecular studies and can be applied in many laboratories. This study retrospectively compares the diagnostic accuracy of cytology samples with and without immunocytochemistry and calculates the frequency of immunocytochemical marker use, as well as sensitivity and specificity rates. Methods: Between 2015 and 2023, 1816 samples from 1506 patients with a histological diagnosis after cytological examination thyroidectomy-lobectomy were included. Cases without a histological diagnosis were excluded. The Thin Prep method was used for all cytological sample preparations, and cell blocks were obtained. Demographic information, Bethesda system categories, immunocytochemical markers used, and histological diagnoses were recorded. Cases using at least one immunocytochemical marker were re-evaluated, and staining results were categorized as positive, focally positive, or negative. SPSS 15 software was used to assess data normality and perform statistical analyses. Results: The most frequently used markers were HBME-1 n167, CK 19 n106, Galectin-3 n75, and CD 56 n6. Sensitivity rates for HBME-1, CK 19, Galectin-3, and CD 56 were 91, 94, 76, and 75, respectively; specificity rates were 63, 61, 80, and 50, respectively. Comparing groups with and without immunocytochemistry, the risk of malignancy was: 6.95-6.97 for Bethesda category II; 21.7-19.0 for Bethesda category III; 76.0-37.1 for Bethesda category IV; 94.0-95.0 for category V; and 100 for category VI. Conclusion: In the follicular neoplasm group Bethesda category IV the risk of malignancy was higher in the immunohistochemistry applied group. No significant difference in malignancy risk was observed between groups with and without immunocytochemistry in other categories. Considering that immunocytochemical markers were predominantly applied in diagnostically challenging Bethesda categories, the similar malignancy risks across groups may suggest immunocytochemistry aids in accurate categorization. However, according to the results of this study, routine use of immunohistochemical markers in thyroid cytology is unnecessary except for Bethesda category IV.

Article Details

The Effects of Immunocytochemistry on Diagnostic Accuracy in Thyroid Fine Needle Aspiration Cytology: A Retrospective Study

Authors: Ali Mızrak | Cansu Benli Işık | Esen Gül Uzuner | Saime Gül Barut

Publisher: Marmara University

Main Topics: Pathology

Journal: Clinical and Experimental Health Sciences Vol.15 Issue 3, pp.531-537

Document Type: Article

Publication Date: 9/2025

Document Language: English

Document ID (Org No.): 2001359598

pISSN: 2459-1459

CK 19

Galectin-3

HBME-1

Immunocytochemistry

Thyroid

Issues

Authors:

Ali Mızrak | Cansu Benli Işık | Esen Gül Uzuner | Saime Gül Barut

Publisher:

Marmara University

Main Topics:

Pathology

Journal:

Clinical and Experimental Health Sciences Vol.15 Issue 3, pp.531-537

Document Type:

Article

Publication Date:

9/2025

Document Language:

English

Document ID (Org No.):

2001359598

pISSN:

2459-1459