ROLE OF HBME-1 IN DIFFERENTIATING SURGICALLY EXCISED THYROID NODULES

Dr. Naznin Nahar Momin*, Dr. M Shahab Uddin Aahmad, Mohammad Ismail Hossain, Dr. Sharmin Ashraf Rima, Dr. Taniza Farnaz and Dr. Mohammad Zillur Rahman

ABSTRACT

Thyroid nodules represent a wide spectrum of neoplasms with different biological behaviors and thyroid follicular epithelial carcinomas are the most common carcinoma of the endocrine system. Histological evaluation is the gold standard in the diagnosis of thyroid nodules, however, similar morphological features put a burden on pathologist while trying to make diagnosis on H & E slides. The use of immunohistochemical markers offers advantage in cases where histomorphological details are insufficient to establish a definitive diagnosis. The aim of this study to evaluate the role of HBME-1 in Differentiating Surgically Excised Thyroid Nodules. Immunohistochemistry method may plays a complementary role to clarify diagnostic dilemma. Materials and Methods: This is a cross sectional study which was conducted in the Department of Pathology, Chittagong Medical College, Chattogram during the period of March, 2019 to February, 2021 with 63 surgically excised thyroid nodule patients attending in Department of ENT, Chittagong Medical College Hospital and other private hospitals in chattogram. All collected samples were processed for routine histopathological study and selected for immunohistochemistry with HBME-1 antibody. Immunohistochemistry was done at Armed Forces Institute of Pathology, Dhaka Cantonment. Immunostaining was done by using primary antibody HBME-1 (Anti–Mesothelioma mouse monoclonal antibody HBME-1 1ab2383.Abcam, UK). Patient’s demographic data were collected and recorded in a pre-designed data sheet. Statistical analysis was carried out as required. Ethical practice was ensured in every step of the study. Results and observations: In this study the mean age was 39.47 ± 13.67 and male to female ratio was 1: 6.9. Thirty-four patients (76.3%) had multiple nodules and 29 patients had history of consuming iodized salt. Forty-three (68.3%) cases were histomorphologically diagnosed as benign and 20 cases (31.7%) as malignant thyroid nodules according to the 2017 WHO classification of thyroid tumors. In the study, HBME-1 positive expression was showed in 17 cases (85%) out of 20 cases of malignant nodules and expression was not observed in benign nodules. The expression of HBME-1 was not statistically significant (p>0.250) means no difference was observed between histopathological examination and HBME-1 expression for diagnosis of benign and malignant nodules. Conclusion: Positive HBME-1 staining is a strong indicator of malignancy, although negative staining does not rule it out. The utilization of HBME-1 markers along with histomorphological evaluation is supportive in the differential diagnosis of thyroid nodules.

Keywords: Thyroidnodules, lymphangiogenesis, metastasis.