Cyto-Histological Correlation of Thyroid Lesions with Estrogen and Progesterone Receptor Status on Neoplastic Lesions 811-815
Dr. Shilpi Bhargava
Department of Pathology.
Subharti Medical College, Meerut, India -250003.
Introduction: Thyroid nodules are common clinical findings, they are more common in women and this incidence increases with age, a history of radiation exposure and with a diet which contains goitrogenic material. Fine needle aspiration cytology (FNAC) is an established technique for the investigation of thyroid nodules. The aim of the present study was to establish a correlation between the cytological features and the histomorphology of various neoplastic and non-neoplastic lesions. Secondly, we aimed to analyze the oestrogen receptor (ER) and the progesterone receptor (PR) status in malignant thyroid tumours.
Materials and Methods: The FNAC of 448 thyroid lesions was performed, with the histological correlation being available in 122 cases, over a period of 5 years. Immunohistochemistry was performed on the neoplastic lesions by the peroxidase- anti-peroxidase technique by using a mouse monoclonal antibody clone.
Results: A cyto-histological discrepancy was noted in 8 cases. On considering histological diagnosis as the gold standard, the overall accuracy was found to be 92.9%.The male:female ratio was 1:7.2 and the maximum number of cases belonged to the nodular colloid goiter category (82.36%). An immunohistochemical analysis for ER and PR was performed on 11 cases of thyroid malignancy, with a single case of papillary carcinoma showing focal nuclear positivity for the progesterone receptors.
Conclusion: The focal nuclear PR positivity which was seen in a single case cannot predict the biological behaviour of the tumour and thus, the use of anti-oestrogenic drugs like tamoxifen is questionable for the management of thyroid cancer. This needs to be confirmed further by taking up similar studies with a larger number of cases.