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The monoclonal antibody against HBME-1 targets an unknown antigen of mesothelial microvilli (1). HBME-1 is abnormally expressed in thyroid cancer, showing cytoplasmic location with membrane accentuation (2-5). Anti-HBME-1 has been most extensively investigated as an immunochemical (IHC) marker in thyroid cancer. It has a sensitivity of 78.3% and specificity of 85.4% in 10 studies using preoperative fine needle aspirate (FNA) specimens (3,5). Similar sensitivity of 77% and specificity of 83% have been reported in meta-analysis of 21 IHC studies on formalin-fixed paraffin-embedded tissue sections (4). Most papillary thyroid carcinomas (PTC) show diffuse positive staining for HBME-1 (55%–100%; mean, 88%) (1). One study has reported a sensitivity of 70% and 45% for the classical and follicular variant of PTC, respectively (1). HBME-1 detection in thyroid follicular carcinomas in different studies has varied between 50% and 100% (mean, 75%) (1). A small series of an oncocytic variant of papillary and follicular carcinoma have demonstrated positive HBME-1 staining in 13% to 66% of cases (1). Poorly differentiated and anaplastic carcinomas also often express HBME-1 (67%–91% and 0%–50%, respectively) (1). HBME-1 is stronglyexpressed in mesothelium, bronchial epithelium, endocervical epithelium and cartilage; variably positive or focal positive in alveolar lining cells of the lung, myoepithelium of breast ducts, endometrial glands with luminal (apical) staining pattern and scattered histiocytes in lymphoid tissue. HBME-1 is negative in epithelium of GI tract, squamous epithelium, liver, kidney, testis, thyroid, placenta, connective tissue, muscle (skeletal and smooth), skin epidermis and dermis and lymphoid tissue (1-5).
Papillary thyroid carcinoma
1. Fischer S, Asa SL. Application of immunohistochemistry to thyroid carcinoma. Arch Pathol Lab Med. 2008; 132:359-72.
2. Sack MJ, et al. HBME-1 immunostaining in thyroid fine-needle aspirations: a useful marker in the diagnosis of carcinoma. Mod Pathol. 1997; 10:668–74.
3. Rodrigues HGC, et al. Use of molecular markers in samples obtained from preoperative aspiration of thyroid. Endocr J. 2012; 59:417–24.
4. de Matos LL, et al. Expression of CK-19, galectin-3 and HBME-1 in the differentiation of thyroid lesions: systematic review and diagnostic meta-analysis. Diagn Pathol. 2012; 7:97.
5. Zhang L, et al. A pilot study of galectin-3, HBME-1, and p27 triple immunostaining pattern for diagnosis of indeterminate thyroid nodules in cytology with the correlation to histology. Appl Immunohistochem Mol Morphol. 2015; 23:481–90.
6. Center for Disease Control Manual. Guide: Safety Management, NO. CDC-22, Atlanta, GA. April 30, 1976 “Decontamination of Laboratory Sink Drains to Remove Azide Salts.”
7. Clinical and Laboratory Standards Institute (CLSI). Protection of Laboratory Workers from Occupationally Acquired Infections; Approved Guideline-Fourth Edition CLSI document M29-A4 Wayne, PA 2014.