NRAS Q61R immunohistochemical staining in thyroid pathology: Sensitivity, specificity and utility Journal Article


Authors: Saliba, M.; Katabi, N.; Dogan, S.; Xu, B.; Ghossein, R. A.
Article Title: NRAS Q61R immunohistochemical staining in thyroid pathology: Sensitivity, specificity and utility
Abstract: Aims: The diagnosis of thyroid neoplasms relies upon the demonstration of histological parameters that can be focal and prone to subjective interpretation. We evaluated the utility of NRAS Q61R immunohistochemistry (IHC) in the diagnosis of thyroid lesions after determining its specificity and sensitivity as a surrogate marker for RAS Q61R mutation. Method and results: NRAS Q61R IHC was performed on 282 primary or metastatic thyroid lesions from 256 patients. RAS mutation status was collected from patients’ charts. Sensitivity and specificity of NRAS Q61R IHC for detecting a RAS Q61R mutation was calculated. IHC-positive cases were reviewed to determine the diagnostic utility of NRAS Q61R IHC. NRAS Q61R immunopositivity was seen in non-neoplastic, benign and malignant thyroid lesions. NRAS Q61R antibody cross-reactivity led to the detection of NRAS Q61R, KRAS Q61R and HRAS Q61R proteins. Among primary thyroid carcinomas, immunopositivity was most frequent in papillary thyroid carcinomas, follicular variant (48.0%). The sensitivity and specificity of NRAS Q61R IHC in detecting RAS Q61R mutation was 90.6% and 92.3%, respectively. When positive, the NRAS Q61R stain was determined to be helpful in demonstrating infiltration, tumour size, capsular and/or vascular invasion and multifocality. Conclusion: NRAS Q61R IHC is highly sensitive and specific for the detection of RAS Q61R mutations in thyroid pathology and is particularly relevant in follicular-patterned neoplasms. When evaluated alongside histological features, NRAS Q61R immunoreactivity can be instrumental in the diagnosis and classification of thyroid nodules. © 2021 John Wiley & Sons Ltd
Keywords: immunohistochemistry; thyroid neoplasms; papillary thyroid carcinoma; nras q61r
Journal Title: Histopathology
Volume: 79
Issue: 4
ISSN: 0309-0167
Publisher: Wiley Blackwell  
Date Published: 2021-10-01
Start Page: 650
End Page: 660
Language: English
DOI: 10.1111/his.14396
PUBMED: 33960437
PROVIDER: scopus
PMCID: PMC8458224
DOI/URL:
Notes: Article -- Export Date: 1 October 2021 -- Source: Scopus
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MSK Authors
  1. Ronald A Ghossein
    485 Ghossein
  2. Nora Katabi
    306 Katabi
  3. Snjezana Dogan
    189 Dogan
  4. Bin   Xu
    229 Xu
  5. Maelle Fouad Saliba
    21 Saliba