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Colato C, Vicentini C, Cantara S, Pedron S, Brazzarola P, Marchetti I, Di Coscio G, Chilosi M, Brunelli M, Pacini F, Ferdeghini M. Break-apart interphase fluorescence in situ hybridization assay in papillary thyroid carcinoma: on the road to optimizing the cut-off level for RET/PTC rearrangements. Eur J Endocrinol 2015; 172:571-82. [PMID: 25698220 DOI: 10.1530/eje-14-0930] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Chromosomal rearrangements of the RET proto-oncogene is one of the most common molecular events in papillary thyroid carcinoma (PTC). However, their pathogenic role and clinical significance are still debated. This study aimed to investigate the prevalence of RET/PTC rearrangement in a cohort of BRAF WT PTCs by fluorescence in situ hybridization (FISH) and to search a reliable cut-off level in order to distinguish clonal or non-clonal RET changes. DESIGN Forty BRAF WT PTCs were analyzed by FISH for RET rearrangements. As controls, six BRAFV600E mutated PTCs, 13 follicular adenomas (FA), and ten normal thyroid parenchyma were also analyzed. METHODS We performed FISH analysis on formalin-fixed, paraffin-embedded tissue using a commercially available RET break-apart probe. A cut-off level equivalent to 10.2% of aberrant cells was accepted as significant. To validate FISH results, we analyzed the study cohort by qRT-PCR. RESULTS Split RET signals above the cut-off level were observed in 25% (10/40) of PTCs, harboring a percentage of positive cells ranging from 12 to 50%, and in one spontaneous FA (1/13, 7.7%). Overall, the data obtained by FISH matched well with qRT-PCR results. Challenging findings were observed in five cases showing a frequency of rearrangement very close to the cut-off. CONCLUSIONS FISH approach represents a powerful tool to estimate the ratio between broken and non-broken RET tumor cells. Establishing a precise FISH cut-off may be useful in the interpretation of the presence of RET rearrangement, primarily when this strategy is used for cytological evaluation or for targeted therapy.
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Affiliation(s)
- Chiara Colato
- Department of Pathology and DiagnosticsARC-NET Research CentreUniversity of Verona, Policlinico GB Rossi, Piazzale LA Scuro, 10, Piastra Odontoiatrica (II floor), 37134 Verona, ItalyDepartment of Internal MedicineEndocrinology, and Metabolism and Biochemistry, University of Siena, Siena, ItalyDepartment of Surgery and OncologyUniversity of Verona, Verona, ItalyDivision of SurgicalMolecular and Ultrastructural, Section of Cytopathology, University Hospital of Pisa, Pisa, ItalyNuclear Medicine UnitUniversity Hospital of Verona, Verona, Italy
| | - Caterina Vicentini
- Department of Pathology and DiagnosticsARC-NET Research CentreUniversity of Verona, Policlinico GB Rossi, Piazzale LA Scuro, 10, Piastra Odontoiatrica (II floor), 37134 Verona, ItalyDepartment of Internal MedicineEndocrinology, and Metabolism and Biochemistry, University of Siena, Siena, ItalyDepartment of Surgery and OncologyUniversity of Verona, Verona, ItalyDivision of SurgicalMolecular and Ultrastructural, Section of Cytopathology, University Hospital of Pisa, Pisa, ItalyNuclear Medicine UnitUniversity Hospital of Verona, Verona, Italy
| | - Silvia Cantara
- Department of Pathology and DiagnosticsARC-NET Research CentreUniversity of Verona, Policlinico GB Rossi, Piazzale LA Scuro, 10, Piastra Odontoiatrica (II floor), 37134 Verona, ItalyDepartment of Internal MedicineEndocrinology, and Metabolism and Biochemistry, University of Siena, Siena, ItalyDepartment of Surgery and OncologyUniversity of Verona, Verona, ItalyDivision of SurgicalMolecular and Ultrastructural, Section of Cytopathology, University Hospital of Pisa, Pisa, ItalyNuclear Medicine UnitUniversity Hospital of Verona, Verona, Italy
| | - Serena Pedron
- Department of Pathology and DiagnosticsARC-NET Research CentreUniversity of Verona, Policlinico GB Rossi, Piazzale LA Scuro, 10, Piastra Odontoiatrica (II floor), 37134 Verona, ItalyDepartment of Internal MedicineEndocrinology, and Metabolism and Biochemistry, University of Siena, Siena, ItalyDepartment of Surgery and OncologyUniversity of Verona, Verona, ItalyDivision of SurgicalMolecular and Ultrastructural, Section of Cytopathology, University Hospital of Pisa, Pisa, ItalyNuclear Medicine UnitUniversity Hospital of Verona, Verona, Italy
| | - Paolo Brazzarola
- Department of Pathology and DiagnosticsARC-NET Research CentreUniversity of Verona, Policlinico GB Rossi, Piazzale LA Scuro, 10, Piastra Odontoiatrica (II floor), 37134 Verona, ItalyDepartment of Internal MedicineEndocrinology, and Metabolism and Biochemistry, University of Siena, Siena, ItalyDepartment of Surgery and OncologyUniversity of Verona, Verona, ItalyDivision of SurgicalMolecular and Ultrastructural, Section of Cytopathology, University Hospital of Pisa, Pisa, ItalyNuclear Medicine UnitUniversity Hospital of Verona, Verona, Italy
| | - Ivo Marchetti
- Department of Pathology and DiagnosticsARC-NET Research CentreUniversity of Verona, Policlinico GB Rossi, Piazzale LA Scuro, 10, Piastra Odontoiatrica (II floor), 37134 Verona, ItalyDepartment of Internal MedicineEndocrinology, and Metabolism and Biochemistry, University of Siena, Siena, ItalyDepartment of Surgery and OncologyUniversity of Verona, Verona, ItalyDivision of SurgicalMolecular and Ultrastructural, Section of Cytopathology, University Hospital of Pisa, Pisa, ItalyNuclear Medicine UnitUniversity Hospital of Verona, Verona, Italy
| | - Giancarlo Di Coscio
- Department of Pathology and DiagnosticsARC-NET Research CentreUniversity of Verona, Policlinico GB Rossi, Piazzale LA Scuro, 10, Piastra Odontoiatrica (II floor), 37134 Verona, ItalyDepartment of Internal MedicineEndocrinology, and Metabolism and Biochemistry, University of Siena, Siena, ItalyDepartment of Surgery and OncologyUniversity of Verona, Verona, ItalyDivision of SurgicalMolecular and Ultrastructural, Section of Cytopathology, University Hospital of Pisa, Pisa, ItalyNuclear Medicine UnitUniversity Hospital of Verona, Verona, Italy
| | - Marco Chilosi
- Department of Pathology and DiagnosticsARC-NET Research CentreUniversity of Verona, Policlinico GB Rossi, Piazzale LA Scuro, 10, Piastra Odontoiatrica (II floor), 37134 Verona, ItalyDepartment of Internal MedicineEndocrinology, and Metabolism and Biochemistry, University of Siena, Siena, ItalyDepartment of Surgery and OncologyUniversity of Verona, Verona, ItalyDivision of SurgicalMolecular and Ultrastructural, Section of Cytopathology, University Hospital of Pisa, Pisa, ItalyNuclear Medicine UnitUniversity Hospital of Verona, Verona, Italy
| | - Matteo Brunelli
- Department of Pathology and DiagnosticsARC-NET Research CentreUniversity of Verona, Policlinico GB Rossi, Piazzale LA Scuro, 10, Piastra Odontoiatrica (II floor), 37134 Verona, ItalyDepartment of Internal MedicineEndocrinology, and Metabolism and Biochemistry, University of Siena, Siena, ItalyDepartment of Surgery and OncologyUniversity of Verona, Verona, ItalyDivision of SurgicalMolecular and Ultrastructural, Section of Cytopathology, University Hospital of Pisa, Pisa, ItalyNuclear Medicine UnitUniversity Hospital of Verona, Verona, Italy
| | - Furio Pacini
- Department of Pathology and DiagnosticsARC-NET Research CentreUniversity of Verona, Policlinico GB Rossi, Piazzale LA Scuro, 10, Piastra Odontoiatrica (II floor), 37134 Verona, ItalyDepartment of Internal MedicineEndocrinology, and Metabolism and Biochemistry, University of Siena, Siena, ItalyDepartment of Surgery and OncologyUniversity of Verona, Verona, ItalyDivision of SurgicalMolecular and Ultrastructural, Section of Cytopathology, University Hospital of Pisa, Pisa, ItalyNuclear Medicine UnitUniversity Hospital of Verona, Verona, Italy
| | - Marco Ferdeghini
- Department of Pathology and DiagnosticsARC-NET Research CentreUniversity of Verona, Policlinico GB Rossi, Piazzale LA Scuro, 10, Piastra Odontoiatrica (II floor), 37134 Verona, ItalyDepartment of Internal MedicineEndocrinology, and Metabolism and Biochemistry, University of Siena, Siena, ItalyDepartment of Surgery and OncologyUniversity of Verona, Verona, ItalyDivision of SurgicalMolecular and Ultrastructural, Section of Cytopathology, University Hospital of Pisa, Pisa, ItalyNuclear Medicine UnitUniversity Hospital of Verona, Verona, Italy Department of Pathology and DiagnosticsARC-NET Research CentreUniversity of Verona, Policlinico GB Rossi, Piazzale LA Scuro, 10, Piastra Odontoiatrica (II floor), 37134 Verona, ItalyDepartment of Internal MedicineEndocrinology, and Metabolism and Biochemistry, University of Siena, Siena, ItalyDepartment of Surgery and OncologyUniversity of Verona, Verona, ItalyDivision of SurgicalMolecular and Ultrastructural, Section of Cytopathology, University Hospital of Pisa, Pisa, ItalyNuclear Medicine UnitUniversity Hospital of Verona, Verona, Italy
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Decaussin-Petrucci M, Deladoëy J, Hafdi-Nejjari Z, Sassolas G, Borson-Chazot F, Abu-Khudir R, Fusco A, Descotes F, Cournoyer S, Sartelet H. Expression of CD133 in differentiated thyroid cancer of young patients. J Clin Pathol 2015; 68:434-40. [PMID: 25770162 DOI: 10.1136/jclinpath-2014-202625] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 02/04/2015] [Indexed: 01/17/2023]
Abstract
AIMS CD133 expression in cancer is frequently associated with poor outcome. Thyroid carcinomas are rare in childhood and adolescence and are associated with a higher risk of recurrence and more metastases than the adult tumours. The aim of the study was to assess whether the expression of CD133 in thyroid carcinomas of children, adolescents and young adults was correlated with clinical prognostic factors. METHODS Tissue microarrays were constructed with 235 tumours coming from 208 young adults with a median age of 28 years and 27 children with a median age of 13 years. An immunohistochemical study was performed with anti-CD133 antibody. CD133 expression was evaluated, using a semiquantitative score based on the percentage of positive cells. The mutation status of tumours was evaluated by reverse transcriptase PCR. Three cell lines were used to confirm CD133 expression by western blot. RESULTS CD133 expression was found in 43% of adult and 37% of child tumours and was confirmed by western blot in cell lines. In young adults, the expression of CD133 was significantly more frequent in patients with tumours >3 cm (p=0.04) and in patients with lymph node metastases (p=0.02). The expression of CD133 was more frequent in patients in whom the tumour presented a BRAF mutation (p=0.03). CONCLUSIONS CD133 expression is correlated with tumour size, lymph nodes metastases and BRAF mutations in young adults. The presence of these cancer stem cells could offer new therapeutic alternatives for aggressive thyroid cancers.
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Affiliation(s)
- Myriam Decaussin-Petrucci
- Department of Pathology, Lyon Sud Hospital Centre, Pierre Bénite, Hospices Civils de Lyon, University Lyon I, Lyon, France
| | - Johnny Deladoëy
- Department of Endocrinology, CHU Sainte Justine, Université de Montréal, Montréal, Quebec, Canada
| | - Zakia Hafdi-Nejjari
- Registre Rhône Alpin des cancers thyroïdiens, Centre de Médecine Nucléaire, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France
| | - Geneviève Sassolas
- Registre Rhône Alpin des cancers thyroïdiens, Centre de Médecine Nucléaire, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France
| | - Françoise Borson-Chazot
- Registre Rhône Alpin des cancers thyroïdiens, Centre de Médecine Nucléaire, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France Department of Endocrinology, Hospices Civils de Lyon, Bron, Université Lyon I, Lyon, France
| | - Rasha Abu-Khudir
- Department of Endocrinology, CHU Sainte Justine, Université de Montréal, Montréal, Quebec, Canada Registre Rhône Alpin des cancers thyroïdiens, Centre de Médecine Nucléaire, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France Department of Endocrinology, Hospices Civils de Lyon, Bron, Université Lyon I, Lyon, France Faculty of Science, Chemistry Department (Biochemistry Branch), Tanta University, Tanta, Egypt
| | - Alfredo Fusco
- Department of Biology and Cellular and Molecular Pathology, Faculty of Medicine and Surgery, Institute of Endocrinology and Experimental Oncology of CNR, Universita degli studi di Napoli Federico II, Naples, Italy
| | - Francoise Descotes
- Department of Biochemistry, Lyon Sud Hospital Centre, Pierre Bénite, Hospices Civils de Lyon, Lyon, France
| | - Sonia Cournoyer
- Department of Pathology, CHU Sainte Justine, Université de Montréal, Montréal, Quebec, Canada
| | - Hervé Sartelet
- Department of Pathology, CHU Sainte Justine, Université de Montréal, Montréal, Quebec, Canada Department of Pathology, Centre Hospitalier Universitaire Robert Debre, Université Paris 7, Paris, France
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53
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Niederer-Wüst SM, Jochum W, Förbs D, Brändle M, Bilz S, Clerici T, Oettli R, Müller J, Haile SR, Ess S, Stoeckli SJ, Broglie MA. Impact of clinical risk scores and BRAF V600E mutation status on outcome in papillary thyroid cancer. Surgery 2015; 157:119-25. [DOI: 10.1016/j.surg.2014.07.015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 07/17/2014] [Indexed: 10/24/2022]
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54
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Tufano RP, Clayman G, Heller KS, Inabnet WB, Kebebew E, Shaha A, Steward DL, Tuttle RM. Management of recurrent/persistent nodal disease in patients with differentiated thyroid cancer: a critical review of the risks and benefits of surgical intervention versus active surveillance. Thyroid 2015; 25:15-27. [PMID: 25246079 DOI: 10.1089/thy.2014.0098] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The primary goals of this interdisciplinary consensus statement are to define the eligibility criteria for management of recurrent and persistent cervical nodal disease in patients with differentiated thyroid cancer (DTC) and to review the risks and benefits of surgical intervention versus active surveillance. METHODS A writing group was convened by the Surgical Affairs Committee of the American Thyroid Association and was tasked with identifying the important clinical elements to consider when managing recurrent/persistent nodal disease in patients with DTC based on the available evidence in the literature and the group's collective experience. SUMMARY The decision on how best to manage individual patients with suspected recurrent/persistent nodal disease is challenging and requires the consideration of a significant number of variables outlined by the members of the interdisciplinary team. Here we report on the consensus opinions that were reached by the writing group regarding the technical and clinical issues encountered in this patient population. CONCLUSIONS Identification of recurrent/persistent disease requires a team decision-making process that includes the patient and physicians as to what, if any, intervention should be performed to best control the disease while minimizing morbidity. Several management principles and variables involved in the decision making for surgery versus active surveillance were developed that should be taken into account when deciding how best to manage a patient with DTC and suspected recurrent or persistent cervical nodal disease.
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Affiliation(s)
- Ralph P Tufano
- 1 Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine , Baltimore, Maryland
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Noh BJ, Sung JY, Kim YW, Park YK. Recurrent thyroid papillary carcinoma in children under ten years old: report of two cases and literature review. KOREAN JOURNAL OF PATHOLOGY 2014; 48:297-301. [PMID: 25214862 PMCID: PMC4160593 DOI: 10.4132/koreanjpathol.2014.48.4.297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 02/18/2014] [Accepted: 02/28/2014] [Indexed: 01/04/2023]
Abstract
Papillary thyroid carcinoma (PTC) in children under ten years old is very rare. To date, 18 cases of PTC in children under ten years old (including our two cases) have been reported in Korea. Here, we describe two cases of recurrent PTC with follicular variant and conventional type in an 8-year-old boy and a 7-year-old boy, respectively, and discuss clinicopathologic and molecular characteristics that differ in pediatric patients from adults.
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Affiliation(s)
- Byeong-Joo Noh
- Department of Pathology, Kyung Hee University School of Medicine, Seoul, Korea
| | - Ji-Youn Sung
- Department of Pathology, Kyung Hee University School of Medicine, Seoul, Korea
| | - Youn-Wha Kim
- Department of Pathology, Kyung Hee University School of Medicine, Seoul, Korea
| | - Yong-Koo Park
- Department of Pathology, Kyung Hee University School of Medicine, Seoul, Korea
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56
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BRAF V600E does not predict aggressive features of pediatric papillary thyroid carcinoma. Laryngoscope 2014; 124:E389-93. [DOI: 10.1002/lary.24668] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 02/24/2014] [Indexed: 11/07/2022]
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Abstract
According to the literature, thyroid nodules (TNs) are quite rare in the first two decades of life and are predominantly non-cancerous, although cancerous TNs are more common in the first two decades of life than in adults. Therefore, it is important for clinicians to distinguish benign from malignant lesions preoperatively because the latter require a total thyroidectomy with or without neck lymph node dissection. A careful work-up and a fine-needle aspiration biopsy (FNAB) are mandatory to improve the preoperative diagnosis. High-resolution thyroid ultrasound and real-time elastosonography are adjuvant presurgical tools in selecting patients for surgery, particularly those with indeterminate or non-diagnostic cytology. Elevated thyroid-stimulating hormone (TSH) level in a patient with a thyroid nodule is a new laboratory predictor of thyroid cancer risk. The majority of thyroid carcinomas derive from the follicular cell, whereas medullary thyroid carcinoma (MTC) derives from calcitonin-producing cells. Patients with MTC are screened for germ-line RET mutations to detect carriers and identify family members for prophylactic or therapeutic thyroidectomy.
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Affiliation(s)
- Marek Niedziela
- Department of Paediatric Endocrinology and Rheumatology, 2nd Chair of Paediatrics, Poznan University of Medical Sciences, 27/33 Szpitalna Street, 60-572 Poznan, Poland.
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58
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Prognostic biomarkers in thyroid cancer. Virchows Arch 2014; 464:333-46. [PMID: 24487783 DOI: 10.1007/s00428-013-1521-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 11/25/2013] [Indexed: 12/23/2022]
Abstract
Thyroid carcinomas represent a challenging problem from the prognostic standpoint. Despite an overall good prognosis of the most frequent endocrine malignancy, 10-15 % of papillary thyroid carcinomas (PTCs) turn refractory to radioactive iodine therapy. The increased incidence of thyroid cancer has led to the search for solid prognostic biomarkers that predict the behaviour of these tumours. Clinical and histopathological prognostic factors remain the only safe elements to be used for diagnosis and prognosis of patients with thyroid tumours. Despite the huge amount of genetic information of thyroid tumours, very few new markers revealed diagnostic or prognostic value per se. BRAF mutation can have some value if associated to other clinico-pathological parameters, or in the particular setting of iodine refractory tumours. Others can prove interesting in the future as predictive biomarkers of therapeutic response, but more studies are needed to confirm these potential biomarkers.
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Kim MH, Bae JS, Lim DJ, Lee H, Jeon SR, Park GS, Jung CK. Quantification of BRAF V600E alleles predicts papillary thyroid cancer progression. Endocr Relat Cancer 2014; 21:891-902. [PMID: 25266729 DOI: 10.1530/erc-14-0147] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The BRAF V600E mutation is the most common genetic alteration in thyroid cancer. However, its clinicopathological significance and clonal mutation frequency remain unclear. To clarify the inconsistent results, we investigated the association between the allelic frequency of BRAF V600E and the clinicopathological features of classic papillary thyroid carcinoma (PTC). Tumour tissues from two independent sets of patients with classic PTC were manually microdissected and analysed for the presence or absence of the BRAF mutation and the mutant allelic frequency using quantitative pyrosequencing. For external validation, the Cancer Genome Atlas (TCGA) data were analysed. The BRAF V600E mutation was found in 264 (82.2%) out of 321 classic PTCs in the training set. The presence of BRAF V600E was only associated with extrathyroidal extension and the absence of thyroiditis. In BRAF V600E-positive tumours, the mutant allelic frequency varied from 8 to 41% of the total BRAF alleles (median, 20%) and directly correlated with tumour size and the number of metastatic lymph nodes. Lymph node metastases were more frequent in PTCs with a high (≥20%) abundance of mutant alleles than in those with a low abundance of mutant alleles (P=0.010). These results were reinforced by validation dataset (n=348) analysis but were not reproduced in the TCGA dataset. In a population with prevalent BRAF mutations, quantitative analysis of the BRAF mutation could provide additional information regarding tumour behaviour, which is not reflected by qualitative analysis. Nonetheless, prospective studies are needed before the mutated allele percentage can be considered as a prognostic factor.
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Affiliation(s)
- Min-Hee Kim
- Division of Endocrinology and MetabolismDepartment of Internal MedicineDepartment of SurgeryDepartment of Hospital PathologyMedical Life SciencesCollege of Medicine, The Catholic University of Korea, 222 Banpodaero, Seocho-gu, Seoul 137-701, Republic of Korea
| | - Ja Seong Bae
- Division of Endocrinology and MetabolismDepartment of Internal MedicineDepartment of SurgeryDepartment of Hospital PathologyMedical Life SciencesCollege of Medicine, The Catholic University of Korea, 222 Banpodaero, Seocho-gu, Seoul 137-701, Republic of Korea
| | - Dong-Jun Lim
- Division of Endocrinology and MetabolismDepartment of Internal MedicineDepartment of SurgeryDepartment of Hospital PathologyMedical Life SciencesCollege of Medicine, The Catholic University of Korea, 222 Banpodaero, Seocho-gu, Seoul 137-701, Republic of Korea
| | - Hyoungnam Lee
- Division of Endocrinology and MetabolismDepartment of Internal MedicineDepartment of SurgeryDepartment of Hospital PathologyMedical Life SciencesCollege of Medicine, The Catholic University of Korea, 222 Banpodaero, Seocho-gu, Seoul 137-701, Republic of Korea
| | - So Ra Jeon
- Division of Endocrinology and MetabolismDepartment of Internal MedicineDepartment of SurgeryDepartment of Hospital PathologyMedical Life SciencesCollege of Medicine, The Catholic University of Korea, 222 Banpodaero, Seocho-gu, Seoul 137-701, Republic of Korea Division of Endocrinology and MetabolismDepartment of Internal MedicineDepartment of SurgeryDepartment of Hospital PathologyMedical Life SciencesCollege of Medicine, The Catholic University of Korea, 222 Banpodaero, Seocho-gu, Seoul 137-701, Republic of Korea
| | - Gyeong Sin Park
- Division of Endocrinology and MetabolismDepartment of Internal MedicineDepartment of SurgeryDepartment of Hospital PathologyMedical Life SciencesCollege of Medicine, The Catholic University of Korea, 222 Banpodaero, Seocho-gu, Seoul 137-701, Republic of Korea
| | - Chan Kwon Jung
- Division of Endocrinology and MetabolismDepartment of Internal MedicineDepartment of SurgeryDepartment of Hospital PathologyMedical Life SciencesCollege of Medicine, The Catholic University of Korea, 222 Banpodaero, Seocho-gu, Seoul 137-701, Republic of Korea
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Ricarte-Filho JC, Li S, Garcia-Rendueles ME, Montero-Conde C, Voza F, Knauf JA, Heguy A, Viale A, Bogdanova T, Thomas GA, Mason CE, Fagin JA. Identification of kinase fusion oncogenes in post-Chernobyl radiation-induced thyroid cancers. J Clin Invest 2013; 123:4935-44. [PMID: 24135138 PMCID: PMC3809792 DOI: 10.1172/jci69766] [Citation(s) in RCA: 168] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Accepted: 08/12/2013] [Indexed: 12/24/2022] Open
Abstract
Exposure to ionizing radiation during childhood markedly increases the risk of developing papillary thyroid cancer. We examined tissues from 26 Ukrainian patients with thyroid cancer who were younger than 10 years of age and living in contaminated areas during the time of the Chernobyl nuclear reactor accident. We identified nonoverlapping somatic driver mutations in all 26 cases through candidate gene assays and next-generation RNA sequencing. We found that 22 tumors harbored fusion oncogenes that arose primarily through intrachromosomal rearrangements. Altogether, 23 of the oncogenic drivers identified in this cohort aberrantly activate MAPK signaling, including the 2 somatic rearrangements resulting in fusion of transcription factor ETS variant 6 (ETV6) with neurotrophic tyrosine kinase receptor, type 3 (NTRK3) and fusion of acylglycerol kinase (AGK) with BRAF. Two other tumors harbored distinct fusions leading to overexpression of the nuclear receptor PPARγ. Fusion oncogenes were less prevalent in tumors from a cohort of children with pediatric thyroid cancers that had not been exposed to radiation but were from the same geographical regions. Radiation-induced thyroid cancers provide a paradigm of tumorigenesis driven by fusion oncogenes that activate MAPK signaling or, less frequently, a PPARγ-driven transcriptional program.
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Affiliation(s)
- Julio C. Ricarte-Filho
- Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Department of Physiology and Biophysics, Weill Cornell Medical College, New York, New York, USA.
The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medical College, New York, New York, USA.
Department of Medicine and
Genomics Core, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Institute of Endocrinology and Metabolism, Kiev, Ukraine.
Department of Surgery and Cancer, Imperial College, Charing Cross Hospital, London, United Kingdom
| | - Sheng Li
- Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Department of Physiology and Biophysics, Weill Cornell Medical College, New York, New York, USA.
The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medical College, New York, New York, USA.
Department of Medicine and
Genomics Core, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Institute of Endocrinology and Metabolism, Kiev, Ukraine.
Department of Surgery and Cancer, Imperial College, Charing Cross Hospital, London, United Kingdom
| | - Maria E.R. Garcia-Rendueles
- Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Department of Physiology and Biophysics, Weill Cornell Medical College, New York, New York, USA.
The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medical College, New York, New York, USA.
Department of Medicine and
Genomics Core, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Institute of Endocrinology and Metabolism, Kiev, Ukraine.
Department of Surgery and Cancer, Imperial College, Charing Cross Hospital, London, United Kingdom
| | - Cristina Montero-Conde
- Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Department of Physiology and Biophysics, Weill Cornell Medical College, New York, New York, USA.
The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medical College, New York, New York, USA.
Department of Medicine and
Genomics Core, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Institute of Endocrinology and Metabolism, Kiev, Ukraine.
Department of Surgery and Cancer, Imperial College, Charing Cross Hospital, London, United Kingdom
| | - Francesca Voza
- Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Department of Physiology and Biophysics, Weill Cornell Medical College, New York, New York, USA.
The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medical College, New York, New York, USA.
Department of Medicine and
Genomics Core, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Institute of Endocrinology and Metabolism, Kiev, Ukraine.
Department of Surgery and Cancer, Imperial College, Charing Cross Hospital, London, United Kingdom
| | - Jeffrey A. Knauf
- Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Department of Physiology and Biophysics, Weill Cornell Medical College, New York, New York, USA.
The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medical College, New York, New York, USA.
Department of Medicine and
Genomics Core, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Institute of Endocrinology and Metabolism, Kiev, Ukraine.
Department of Surgery and Cancer, Imperial College, Charing Cross Hospital, London, United Kingdom
| | - Adriana Heguy
- Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Department of Physiology and Biophysics, Weill Cornell Medical College, New York, New York, USA.
The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medical College, New York, New York, USA.
Department of Medicine and
Genomics Core, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Institute of Endocrinology and Metabolism, Kiev, Ukraine.
Department of Surgery and Cancer, Imperial College, Charing Cross Hospital, London, United Kingdom
| | - Agnes Viale
- Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Department of Physiology and Biophysics, Weill Cornell Medical College, New York, New York, USA.
The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medical College, New York, New York, USA.
Department of Medicine and
Genomics Core, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Institute of Endocrinology and Metabolism, Kiev, Ukraine.
Department of Surgery and Cancer, Imperial College, Charing Cross Hospital, London, United Kingdom
| | - Tetyana Bogdanova
- Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Department of Physiology and Biophysics, Weill Cornell Medical College, New York, New York, USA.
The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medical College, New York, New York, USA.
Department of Medicine and
Genomics Core, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Institute of Endocrinology and Metabolism, Kiev, Ukraine.
Department of Surgery and Cancer, Imperial College, Charing Cross Hospital, London, United Kingdom
| | - Geraldine A. Thomas
- Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Department of Physiology and Biophysics, Weill Cornell Medical College, New York, New York, USA.
The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medical College, New York, New York, USA.
Department of Medicine and
Genomics Core, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Institute of Endocrinology and Metabolism, Kiev, Ukraine.
Department of Surgery and Cancer, Imperial College, Charing Cross Hospital, London, United Kingdom
| | - Christopher E. Mason
- Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Department of Physiology and Biophysics, Weill Cornell Medical College, New York, New York, USA.
The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medical College, New York, New York, USA.
Department of Medicine and
Genomics Core, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Institute of Endocrinology and Metabolism, Kiev, Ukraine.
Department of Surgery and Cancer, Imperial College, Charing Cross Hospital, London, United Kingdom
| | - James A. Fagin
- Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Department of Physiology and Biophysics, Weill Cornell Medical College, New York, New York, USA.
The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medical College, New York, New York, USA.
Department of Medicine and
Genomics Core, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
Institute of Endocrinology and Metabolism, Kiev, Ukraine.
Department of Surgery and Cancer, Imperial College, Charing Cross Hospital, London, United Kingdom
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Abstract
Thyroid carcinoma is a rare disease in children, and is mostly of the papillary histological type. Lymph node metastases are frequent at diagnosis, being present in 23 to 74% of the cases and can reveal the cancer in about one fourth of cases. Lung metastases are present at initial diagnosis in 6 to 20% of cases. The main known risk factor for thyroid cancer is a previous history of radiation exposure. Treatment includes surgery with total thyroidectomy and lymph node dissection and radioiodine therapy in case of extensive disease and distant metastases. Life-long thyroxine treatment is given to all patients. Long term prognosis is favourable, but thyroid cancer related deaths have been reported some decades after initial treatment.
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Romei C, Fugazzola L, Puxeddu E, Frasca F, Viola D, Muzza M, Moretti S, Nicolosi ML, Giani C, Cirello V, Avenia N, Rossi S, Vitti P, Pinchera A, Elisei R. Modifications in the papillary thyroid cancer gene profile over the last 15 years. J Clin Endocrinol Metab 2012; 97:E1758-65. [PMID: 22745248 DOI: 10.1210/jc.2012-1269] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Evidence for an increased prevalence of BRAF(V600E) mutations has been documented in recent decades. The aim of this study was to evaluate the prevalence of both RET/PTC rearrangements and BRAF(V600E) mutations in an Italian cohort of papillary thyroid carcinoma (PTC) patients followed at the Endocrine Units of Pisa, Milano, and Perugia from 1996-2010. PATIENTS AND METHODS In total, 401 PTC patients were examined and grouped according to the time of surgery: group 1, 1996-2000; group 2, 2001-2005; and group 3, 2006-2010. Patients were analyzed for clinical, pathological, and molecular features. In parallel, the molecular characteristics of 459 PTC from Sicily were studied. RESULTS The genetic profiles of the three groups were significantly different (P < 0.0001). In particular, the frequency of RET/PTC rearrangements decreased from 1996-2010, occurring in 33 of 100 (33%) of the patients in group 1, 26 of 148 (17%) in group 2, and 15 of 153 (9.8%) in group 3. The incidence of BRAF(V600E) mutations increased over the same period, from 28% in group 1 (28 of 100) to 48.9% in group 2 (73 of 148) and 58.1% in group 3 (89 of 153). A consistent increase in BRAF(V600E) prevalence was observed in the Sicilian group (P < 0.0001). Moreover, a statistically significant increase in the mean age at diagnosis and decrease in tumor size over the study period was observed. CONCLUSION The genetic profile of PTC changed over the last 15 yr, with a significant decrease in the prevalence of RET/PTC rearrangements and an increase in BRAF(V600E) mutations. In addition, the mean age at diagnosis increased and tumor size decreased over the study period.
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Affiliation(s)
- Cristina Romei
- Department of Endocrinology and Metabolism and World Health Organization Collaborating Center for the Study and Treatment of Thyroid Diseases and Other Endocrine and Metabolic Disorders, University of Pisa, 56124 Pisa, Italy
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Sancisi V, Nicoli D, Ragazzi M, Piana S, Ciarrocchi A. BRAFV600E mutation does not mean distant metastasis in thyroid papillary carcinomas. J Clin Endocrinol Metab 2012; 97:E1745-9. [PMID: 22740704 DOI: 10.1210/jc.2012-1526] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CONTEXT The oncogenic BRAFV600E mutation has been frequently associated with aggressive behavior of papillary thyroid carcinomas. However, controversy exists on the consistency of these data, and very little is known about the relationship between this genetic alteration and the tendency of papillary thyroid carcinoma (PTC) to develop metastasis at distant sites. STUDY DESIGN We analyzed by direct sequencing the frequency of BRAFV600E mutation within a group of 47 highly aggressive PTC, which had developed distant metastases. As control, we analyzed the BRAFV600E mutation in a group of 75 PTC without distant metastases who were disease free for a minimum 7-yr follow-up. RESULTS The BRAFV600E mutation was present in 29.8% of the distantly metastatic PTC, whereas it was detected in about 44.0% of the control tumors. CONCLUSION These results clearly prove that the BRAFV600E mutation is not associated with the development of distant metastases or fatal outcome in PTC and may not predict aggressive behavior in this type of tumor.
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Affiliation(s)
- Valentina Sancisi
- Laboratory of Molecular Biology, Department of Oncology, Arcispedale S. Maria Nuova, Azienda Ospedaliera-Instituto di Ricovero e Cura a Carattere Scientifico, Viale Risorgimento 80, 42123 Reggio Emilia, Italy
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Schlumberger M, Le Guen B. [Nuclear-power-plant accidents: thyroid cancer incidence and radiation-related health effects from the Chernobyl accident]. Med Sci (Paris) 2012; 28:746-56. [PMID: 22920877 DOI: 10.1051/medsci/2012288017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Following the Chernobyl accident, enormous amounts of radioisotopes were released in the atmosphere and have contaminated surrounding populations in the absence of rapid protective countermeasures. The highest radiation doses were delivered to the thyroid gland, and the only direct consequence of radiation exposure observed among contaminated population is the increased incidence of thyroid cancers among subjects who were children in 1986 and who lived at that time in Belarus, Ukraine or Russia.
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Affiliation(s)
- Martin Schlumberger
- Université Paris-Sud, service de médecine nucléaire et cancérologie endocrinienne, Institut Gustave Roussy, 94805 Villejuif Cedex, France.
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