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Kalfert D, Ludvikova M, Pesta M, Hakala T, Dostalova L, Grundmannova H, Windrichova J, Houfkova K, Knizkova T, Ludvik J, Polivka J, Kholova I. BRAF mutation, selected miRNAs and genes expression in primary papillary thyroid carcinomas and local lymph node metastases. Pathol Res Pract 2024; 258:155319. [PMID: 38696857 DOI: 10.1016/j.prp.2024.155319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 04/04/2024] [Accepted: 04/16/2024] [Indexed: 05/04/2024]
Abstract
Mutations in cancer-related genes are now known to be accompanied by epigenetic events in carcinogenesis by modification of the regulatory pathways and expression of genes involved in the pathobiology. Such cancer-related mutations, miRNAs and gene expression may be promising molecular markers of the most common papillary thyroid carcinoma (PTC). However, there are limited data on their relationships. The aim of this study was to analyse the interactions between BRAF mutations, selected microRNAs (miR-21, miR-34a, miR-146b, and miR-9) and the expression of selected genes (LGALS3, NKX2-1, TACSTD2, TPO) involved in the pathogenesis of PTC. The study cohort included 60 primary papillary thyroid carcinomas (PTC) that were classified as classical (PTC/C; n=50) and invasive follicular variant (PTC/F; n=10), and 40 paired lymph node metastases (LNM). BRAF mutation status in primary and recurrent/persistent papillary thyroid carcinomas was determined. The mutation results were compared both between primary and metastatic cancer tissue, and between BRAF mutation status and selected genes and miRNA expression in primary PTC. Furthermore, miRNAs and gene expression were compared between primary PTCs and non-neoplastic tissue, and local lymph node metastatic tumor, respectively. All studied markers showed several significant mutual interactions and contexts. In conclusion, to the best our knowledge, this is the first integrated study of BRAF mutational status, the expression levels of mRNAs of selected genes and miRNAs in primary PTC, and paired LNM.
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Affiliation(s)
- David Kalfert
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Motol, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Marie Ludvikova
- Department of Biology, Faculty of Medicine in Pilsen, Charles University, Pilsen 32300, Czech Republic.
| | - Martin Pesta
- Department of Biology, Faculty of Medicine in Pilsen, Charles University, Pilsen 32300, Czech Republic
| | - Tommi Hakala
- The Wellbeing Services County of Pirkanmaa, Department of Surgery, Tampere University Hospital, Tampere, Finland
| | - Lucie Dostalova
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Motol, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Hana Grundmannova
- Laboratory of Immunoanalysis, University Hospital in Pilsen, Pilsen, Czech Republic
| | - Jindra Windrichova
- Laboratory of Immunoanalysis, University Hospital in Pilsen, Pilsen, Czech Republic
| | - Katerina Houfkova
- Department of Biology, Faculty of Medicine in Pilsen, Charles University, Pilsen 32300, Czech Republic
| | - Tereza Knizkova
- Department of Biology, Faculty of Medicine in Pilsen, Charles University, Pilsen 32300, Czech Republic
| | - Jaroslav Ludvik
- Department of Imaging Methods, University Hospital Pilsen, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Jiri Polivka
- Department of Histology and Embryology and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Ivana Kholova
- Pathology, Fimlab Laboratories, Tampere, Finland and Tampere University, Faculty of Medicine and Health Technology, Tampere, Finland
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Cleere EF, Prunty S, O'Neill JP. Anaplastic thyroid cancer:Improved understanding of what remains a deadly disease. Surgeon 2024; 22:e48-e53. [PMID: 37866980 DOI: 10.1016/j.surge.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/03/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Anaplastic thyroid cancer (ATC) is a rare, undifferentiated form of thyroid cancer accounting for less that 2 % of thyroid cancers. Here we provide an overview of the contemporary understanding of ATC as well as discussing in detail any pertinent updates in the molecular understanding and treatment of this disease with reference to the 2021 American Thyroid Association (ATA) guidelines. METHODS A review of the literature regarding the understanding, management and prognosis of ATC was undertaken using both Pubmed and Cochrane databases along with local institutional experience. Studies published in the last 5 years were prioritised for inclusion. RESULTS Between 80 and 90 % of patients will have disease that has spread beyond the thyroid gland at presentation. Despite the use of aggressive, multimodal, conventional treatment strategies encompassing surgery and chemoradiotherapy, the median overall survival has remained between 3 and 6 months. Our understanding has evolved regarding the key oncogenic mutations involved in the development of ATC. These include BRAF, RAS, PI3K, PTEN, TP53 and TERT mutations. There is growing evidence that novel targeted therapies against these mutations may improve outcomes in this disease which has led to FDA approval of dabrafenib/trametinib combined BRAF/Mek inhibition. CONCLUSIONS The prognosis of ATC remains dismal. Recent development and approval of targeted therapies offers hope of improved oncologic outcomes with further data eagerly awaited surrounding the impact of these targeted therapies.
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Affiliation(s)
- Eoin F Cleere
- Department of Otolaryngology-Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland; The Royal College of Surgeons in Ireland, Dublin, Ireland.
| | - Sarah Prunty
- Department of Otolaryngology-Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland; The Royal College of Surgeons in Ireland, Dublin, Ireland
| | - James P O'Neill
- Department of Otolaryngology-Head and Neck Surgery, Beaumont Hospital, Dublin, Ireland; The Royal College of Surgeons in Ireland, Dublin, Ireland
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Ma CX, Ma XN, Liu JJ, Guan CH, Li YD, Zhao N, Mauricio D, Fu SB. The BRAF V600E mutation maintains the aggressiveness of papillary thyroid cancers requiring downregulation of primary cilia. Mol Cell Endocrinol 2024; 581:112113. [PMID: 37989409 DOI: 10.1016/j.mce.2023.112113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/13/2023] [Accepted: 11/15/2023] [Indexed: 11/23/2023]
Abstract
Although disorders of primary cilia (PCs) were first reported in human papillary thyroid cancer (PTC) tissues in 1987, their precise role in PTC remains unclear. PCs sense the thyroid follicle colloid environment and act as a cell signaling hub. The present study investigated whether PCs are needed for BRAFV600E-driven PTC. We assessed whether BRAFV600E protein expression correlates with papillary histological architecture and clinicopathological features of PTC. We found that expression of ciliary intraflagellar transport 88 (IFT88) and PC formation were reduced in BRAFV600E-driven PTCs and that loss of cilia may be associated with lymph node metastasis. In PTC cells, the BRAFV600E mutation maintained the aggressiveness of PTC, which was partially related to loss of PCs. Our work confirms that BRAFV600E mutation-driven PC downregulation contributes to maintaining the aggressiveness of PTCs and that manipulating PC can potentially reduce the adverse incidence of PTC in a range of conditions.
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Affiliation(s)
- Cheng-Xu Ma
- Department of Endocrinology, The First Hospital of Lanzhou University, No. 1 West Donggang Road, Lanzhou, Gansu 730000, China; The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu 730000, China
| | - Xiao-Ni Ma
- Department of Endocrinology, The First Hospital of Lanzhou University, No. 1 West Donggang Road, Lanzhou, Gansu 730000, China; The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu 730000, China
| | - Jin-Jin Liu
- Department of Endocrinology, The First Hospital of Lanzhou University, No. 1 West Donggang Road, Lanzhou, Gansu 730000, China; The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu 730000, China
| | - Cong-Hui Guan
- Department of Endocrinology, The First Hospital of Lanzhou University, No. 1 West Donggang Road, Lanzhou, Gansu 730000, China; The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu 730000, China
| | - Ying-Dong Li
- College of Integrated Traditional Chinese and Western Medicine, Gansu University of Chinese Medicine, Lanzhou, Gansu, 730000, China
| | - Nan Zhao
- Department of Endocrinology, The First Hospital of Lanzhou University, No. 1 West Donggang Road, Lanzhou, Gansu 730000, China; The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu 730000, China
| | - Dídac Mauricio
- Department of Endocrinology & Nutrition, CIBERDEM, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, 08041 Barcelona, Spain.
| | - Song-Bo Fu
- Department of Endocrinology, The First Hospital of Lanzhou University, No. 1 West Donggang Road, Lanzhou, Gansu 730000, China; The First Clinical Medical College of Lanzhou University, Lanzhou, Gansu 730000, China.
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Abdulhaleem M, Bandargal S, Pusztaszeri MP, Rajab M, Greenspoon H, Krasner JR, Da Silva SD, Forest VI, Payne RJ. The Impact of BRAF V600E Mutation Allele Frequency on the Histopathological Characteristics of Thyroid Cancer. Cancers (Basel) 2023; 16:113. [PMID: 38201541 PMCID: PMC10777954 DOI: 10.3390/cancers16010113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND A BRAF V600E mutation in papillary thyroid cancer (PTC) has been shown to be associated with aggressive behavior. Nevertheless, not all BRAF V600E PTCs behave aggressively. Allele frequency (AF) is the number of mutated molecules divided by the total number of wild-type molecules at a specific location in the genome. The relationship between BRAF V600E AF and the histopathological features of thyroid malignancies is not well understood. We hypothesized that the BRAF V600E AF will correlate directly with aggressive histopathological behavior. The aim of this study was to examine this relationship. METHODS A retrospective chart review was performed for patients treated for BRAF V600E thyroid malignancies from 2019 to 2022 at McGill University tertiary care hospitals (n = 317). Patients with BRAF V600E-positive malignancies that included information on AF were included (n = 44). The correlation between AF and tumor histopathological features was analyzed. RESULTS Out of the 44 nodules with a BRAF V600E mutation, those with aggressive features of PTC had a mean AF of 25.8%, which was significantly higher than the non-aggressive group with a mean AF of 10.25% (p = 0.020). Additionally, there was a statistically significant difference in mean AF between patients with a positive sentinel LN (29%) and those with a negative sentinel LN (17.8%) (p = 0.021). Classical PTC was present in 29.5% (13/44) of nodules, with a mean AF of 15.6%. The tall cell subtype was found in 64% (28/44) of nodules, with a mean AF of 23%. Solid and hobnail subtypes were less common in this study, and there was no statistically significant relationship between AF and histopathological subtypes (p = 0.107). Nodules smaller than 1cm had a mean AF of 13.3%, while nodules ranging from 1 2cm had a mean AF of 20.6%, and those larger than 2cm had a mean AF of 27.7%. However, no statistical difference was observed between AF and nodule size (p = 0.160). CONCLUSION In this study, BRAF V600E mutations in conjunction with AF help to determine whether thyroid malignancies will display aggressive behavior. This pre-operative finding can help thyroid specialists to determine the extent of thyroidectomy and whether lymph node dissection is required.
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Affiliation(s)
- Mawaddah Abdulhaleem
- Department of Otolaryngology–Head and Neck Surgery, McGill University, Royal Victoria Hospital, Montreal, QC H4A 3J1, Canada
- Department of Otolaryngology–Head and Neck Surgery, McGill University, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Saruchi Bandargal
- Faculty of Medicine, McGill University, Montreal, QC H3G 2M1, Canada
| | | | - Mohannad Rajab
- Department of Otolaryngology—Head and Neck Surgery, King Faisal Specialist Hospital & Research Center, Al Madinah Al Munawwarah 42523, Saudi Arabia
| | - Hannah Greenspoon
- Faculty of Arts and Science, Queen’s University, Kingston, ON K7L 3N6, Canada
| | | | - Sabrina Daniela Da Silva
- Department of Otolaryngology–Head and Neck Surgery, McGill University, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Véronique-Isabelle Forest
- Department of Otolaryngology–Head and Neck Surgery, McGill University, Royal Victoria Hospital, Montreal, QC H4A 3J1, Canada
- Department of Otolaryngology–Head and Neck Surgery, McGill University, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
| | - Richard J. Payne
- Department of Otolaryngology–Head and Neck Surgery, McGill University, Royal Victoria Hospital, Montreal, QC H4A 3J1, Canada
- Department of Otolaryngology–Head and Neck Surgery, McGill University, Jewish General Hospital, Montreal, QC H3T 1E2, Canada
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Xiao J, Yan L, Li Y, Li X, Yang Z, Zhang M, Luo Y. Radiofrequency ablation for papillary thyroid cancer located in isthmus: comparison with that originated in thyroid lobe. Int J Hyperthermia 2023; 40:2266668. [PMID: 37940133 DOI: 10.1080/02656736.2023.2266668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/29/2023] [Indexed: 11/10/2023] Open
Abstract
PURPOSE To analyze the outcomes of radiofrequency ablation (RFA) for isthmus papillary thyroid cancer (PTC) versus PTC originating from the lobes. METHODS Patients with solitary low-risk PTC treated with RFA between July 2014 and December 2019 were retrospectively reviewed. This study was approved by our institutional review board. Of the 562 patients, 104 and 458 had PTCs located in the thyroid isthmus and thyroid lobes, respectively. Local tumor progression (LTP), LTP-free survival (LTPFS), changes in tumor volume, and complications were compared between the two groups using propensity-score matching (PSM). RESULTS The isthmic and lobar groups showed no significant differences in LTP (2.9% vs. 3.8%), new PTC (2.9% vs. 2.9%), persistent lesions (0.0% vs. 0.2%), or LTPFS after PSM. Before PSM, the two groups showed significant differences in the volume reduction ratio (VRR) of the ablated tumors at 1, 3, 24, 30, and 48 months after RFA, but no differences between the two groups were observed in tumor volume, VRR, or disappearance rate after PSM (p > .05). One patient in the isthmic group presented with coughing, while another complained of hoarseness. Complications did not differ significantly between the two groups (p > .05). CONCLUSIONS The outcomes of RFA for patients with low-risk PTC in the thyroid isthmus and thyroid lobes were similar. Therefore, RFA may serve as an alternative treatment option for patients with low-risk isthmic PTC.
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Affiliation(s)
- Jing Xiao
- Department of Ultrasound, the First Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
| | - Lin Yan
- Department of Ultrasound, the First Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
| | - Yingying Li
- Department of Ultrasound, the First Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
| | - Xinyang Li
- Department of Ultrasound, the First Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
| | - Zhen Yang
- Department of Ultrasound, the First Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
| | - Mingbo Zhang
- Department of Ultrasound, the First Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
| | - Yukun Luo
- Department of Ultrasound, the First Medical Center of Chinese PLA General Hospital, Beijing, P.R. China
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Genetic analysis and clinicopathologic features of locally advanced papillary thyroid cancers: a prospective observational study. J Cancer Res Clin Oncol 2023:10.1007/s00432-022-04541-w. [PMID: 36735028 DOI: 10.1007/s00432-022-04541-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/16/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE Locally advanced papillary thyroid cancer (LAPTC) has poor prognosis. Large-scale genomic testing has revealed multiple oncogenic drivers which may be essential for understanding tumor progression. However, the accurate identification of high recurrence risk and poor prognosis in thyroid carcinoma remains unclear. The objective of this study was to analyze genetic profile and clinicopathologic features of locally advanced papillary thyroid cancers. METHODS An observational cohort study was performed to identify molecular characteristics of LAPTC and a prognosis comparison of LAPTC with different genetic mutations. ThyroSeq v2 next-generation sequencing (57-gene panel) was performed on fresh tumor tissue. Then, the clinicopathological features between tumors with different genetic mutations were compared. Additionally, correlations of tumor recurrence and disease free survival with different genetic alterations were analyzed. RESULTS This study showed that the main mutation is common BRAFV600E (66.2%, 43/65) in LAPTC, followed by the TERT promoter mutations (38.5%, 25/65). Synergetic mutations of BRAFV600E and TERT promoters (B&T) were identified in 26.2% LAPTC (17/65), which is associated with tall-cell variant, extrathyroidal invasion and advanced tumor stage (III/IV). The synergetic mutations of B&T are also significantly associated with higher risk of recurrence (hazard ratio [HR], 6.0; 95% confidence interval, CI 1.26-28.55, P = 0.02) and mortality (17.6%, 3/17). CONCLUSIONS Synergetic mutations of B&T are common in LAPTC, which is associated with the aggressive clinicopathologic features and an increased risk of recurrence and mortality. This finding may help to predict aggressive behavior of LAPTC and to assist in clinical decision-making.
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Prognostic Significance of BRAF V600E Mutation and CPSF2 Protein Expression in Papillary Thyroid Cancer. Biomedicines 2022; 11:biomedicines11010053. [PMID: 36672561 PMCID: PMC9855628 DOI: 10.3390/biomedicines11010053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/04/2022] [Accepted: 12/16/2022] [Indexed: 12/28/2022] Open
Abstract
The early-stage diagnosis of papillary thyroid cancer (PTC) has significantly increased in incidence worldwide without any beneficial impact on survival. In order to improve the risk assessment in PTC, we have conducted a retrospective study in which we analyzed the BRAF V600E mutation and CPSF2 protein expression as prognostic markers on archival tissue samples of 49 patients without (control group) and 97 patients with (study group) PTC metastases in the cervical lymph nodes at the time of initial diagnosis. Our aim was to correlate the BRAF V600E mutation and the expression of CPSF2 protein with the clinical and pathological features of PTC. The expression of CPSF2 protein was evaluated via immunohistochemistry and graded semi-quantitatively. The presence of the BRAF V600E mutation was determined via real-time polymerase chain reac-tion (PCR). CPSF2 protein < 3+ intensity expression was correlated with more frequent recurrences (Fisher-Freeman-Halton exact test; p = 0.010; 95% CI: 1.26−22.03), and patients who presented with the BRAF V600E mutation and CPSF2 protein expression < 3+ intensity had shorter disease-free survival (log-rank test; 105.0 months vs. 146.6 months; p < 0.001; HR 8.32, 95% CI: 2.91−23.83), whereas patients with PTC who had CPSF2 expression 3+ had longer disease-free survival in correlation with other lower intensity expressions of CPSF2 protein (log-rank test; 139.7 months vs. 129.6 months; p = 0.008). The multivariate analysis showed that younger patients with CPSF2 protein expression <3+ and the BRAF V600E mutation are at an increased risk for recurrence and require more intensive monitoring (Cox proportional hazards regression model; X2 = 17.5, df = 10, p = 0.025). Our results correlate the BRAF V600E mutation and CPSF2 protein expression with recurrence and disease-free survival as relevant prognostic factors for PTC.
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Kuchareczko A, Kopczyński J, Kowalik A, Hińcza-Nowak K, Walczyk A, Pałyga I, Trybek T, Szymonek M, Gąsior-Perczak D, Gadawska-Juszczyk K, Mikina E, Płachta I, Suligowska A, Płusa A, Chrapek M, Łopatyński T, Góźdź S, Kowalska A. A Significance of Concomitant BRAF V600E and TERT Mutations in Polish Patients with Papillary Thyroid Microcarcinoma: A Retrospective Cohort Study Based on 430 Cases. Thyroid 2022; 32:1372-1381. [PMID: 35950639 DOI: 10.1089/thy.2022.0155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: The incidence of papillary thyroid cancer is increasing worldwide due to more frequent pathological detection of papillary thyroid microcarcinomas (PTMC), which are cancers measuring 1 cm or less in diameter. In rare cases, the course of PTMC can be aggressive, with an increased risk of recurrence/persistent disease. The aim of this study of Polish patients diagnosed with PTMC was to assess the impact of concomitant B-type Raf kinas-activating mutation in codon 600 of exon 15 (BRAFV600E) and telomerase reverse transcriptase (TERT) hotspot mutations on clinicopathological features, response to treatment, potential recurrence, and the final outcome. Methods: A retrospective analysis of the 430 PTMC cases diagnosed during 2001-2020 at a single center was performed. All PTMC cases were assessed histopathologically, and analyses of BRAFV600E and TERT promoter were performed based on DNA isolated from tumor blocks. Results: There were 29/430 (6.7% [confidence interval: 4.6-9.5]) patients in whom the TERTC228T and/or TERTC250T mutations coexisted with the BRAFV600E mutation. A statistical comparison between PTMC cases with concomitant BRAFV600E and TERT hotspot mutations and those without any of those mutations revealed no significant differences between the two groups with respect to risk stratification, response to primary treatment, clinical course, or final disease status. Conclusion: Regardless of the molecular background of PTMC, the overall response to therapy is excellent, and long-term disease-free survival rates can be achieved by most patients.
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Affiliation(s)
- Artur Kuchareczko
- Department of Oncology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Endocrinology Clinic of Holycross Cancer Centre, Kielce, Poland
| | | | - Artur Kowalik
- Division of Medical Biology, Institute of Biology, Jan Kochanowski University, Kielce, Poland
- Department of Molecular Diagnostics, Holycross Cancer Centre, Kielce, Poland
| | - Kinga Hińcza-Nowak
- Endocrinology Clinic of Holycross Cancer Centre, Kielce, Poland
- Department of Molecular Diagnostics, Holycross Cancer Centre, Kielce, Poland
| | - Agnieszka Walczyk
- Department of Oncology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Endocrinology Clinic of Holycross Cancer Centre, Kielce, Poland
| | - Iwona Pałyga
- Department of Oncology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Endocrinology Clinic of Holycross Cancer Centre, Kielce, Poland
| | - Tomasz Trybek
- Endocrinology Clinic of Holycross Cancer Centre, Kielce, Poland
| | - Monika Szymonek
- Endocrinology Clinic of Holycross Cancer Centre, Kielce, Poland
| | - Danuta Gąsior-Perczak
- Department of Oncology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Endocrinology Clinic of Holycross Cancer Centre, Kielce, Poland
| | | | - Estera Mikina
- Endocrinology Clinic of Holycross Cancer Centre, Kielce, Poland
| | - Izabela Płachta
- Endocrinology Clinic of Holycross Cancer Centre, Kielce, Poland
| | | | - Agnieszka Płusa
- Department of Pathology, Holycross Cancer Centre, Kielce, Poland
| | - Magdalena Chrapek
- Department of Mathematics, Faculty of Natural Sciences, Jan Kochanowski University, Kielce, Poland
| | - Tomasz Łopatyński
- Department of General, Oncologic and Metabolic Surgery, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Stanisław Góźdź
- Department of Oncology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Department of Clinical Oncology, Holycross Cancer Centre, Kielce, Poland
| | - Aldona Kowalska
- Department of Oncology, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
- Endocrinology Clinic of Holycross Cancer Centre, Kielce, Poland
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Wikanta ER, Prajoko YW, Issakh B, Istiadi H, Puspasari D. Relationship Between The BRAF V600E And Tumor Size, Lymph Node, And Distant Metastasis In Papillary Thyroid Carcinoma. RUSSIAN OPEN MEDICAL JOURNAL 2022. [DOI: 10.15275/rusomj.2022.0216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Aim – This study aimed to analyze the association between B-Raf proto-oncogene, serine/threonine kinase (BRAF) V600E and tumor size, lymph node, and distant metastasis (TNM) status on patients with papillary thyroid carcinoma. Material and Methods – This research is a cross-sectional study. A total of 40 samples were papillary thyroid carcinoma tissue paraffin blocks from thyroidectomy surgery at State General Hospital (RSUP) Dr. Kariadi Semarang. Assessment of BRAF V600E mutation protein expression through immunohistochemical methods using antibody BRAF V600E was conducted. Results – The mean age of patients with papillary thyroid carcinoma with a positive BRAF V600E mutation was 49 years. The highest incidence was 71.4% in women. A significant difference between BRAF V600E and tumor size (p=0.03) was observed with as many as 53.2% more cases at size > 4 cm. A significant difference in the expression of BRAF V600E with enlargement of the lymph node (p=0.011) by 60.7% was observed compared to those without enlarged lymph nodes. On the other hand, no significant relationship between BRAF V600E expression and distant metastasis (p=0.652) was observed. The prevalence ratio in the positive BRAF V600E case at tumor size is more than 4 cm, and enlargement of lymph is 9.533 and 7.727. Conclusion – There is a significant relationship between BRAF V600E expression and tumor size and enlarged lymph nodes, while there is no significant relationship between BRAF V600E expression and distant metastases.
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Pharmacological inhibition of Ref-1 enhances the therapeutic sensitivity of papillary thyroid carcinoma to vemurafenib. Cell Death Dis 2022; 13:124. [PMID: 35136031 PMCID: PMC8825860 DOI: 10.1038/s41419-022-04550-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 12/18/2021] [Accepted: 01/13/2022] [Indexed: 12/11/2022]
Abstract
The use of the BRAF inhibitor vemurafenib exhibits drug resistance in the treatment of thyroid cancer (TC), and finding more effective multitarget combination therapies may be an important solution. In the present study, we found strong correlations between Ref-1 high expression and BRAF mutation, lymph node metastasis, and TNM stage. The oxidative stress environment induced by structural activation of BRAF upregulates the expression of Ref-1, which caused intrinsic resistance of PTC to vemurafenib. Combination inhibition of the Ref-1 redox function and BRAF could enhance the antitumor effects of vemurafenib, which was achieved by blocking the action of Ref-1 on BRAF proteins. Furthermore, combination treatment could cause an overload of autophagic flux via excessive AMPK protein activation, causing cell senescence and cell death in vitro. And combined administration of Ref-1 and vemurafenib in vivo suppressed PTC cell growth and metastasis in a cell-based lung metastatic tumor model and xenogeneic subcutaneous tumor model. Collectively, our study provides evidence that Ref-1 upregulation via constitutive activation of BRAF in PTC contributes to intrinsic resistance to vemurafenib. Combined treatment with a Ref-1 redox inhibitor and a BRAF inhibitor could make PTC more sensitive to vemurafenib and enhance the antitumor effects of vemurafenib by further inhibiting the MAPK pathway and activating the excessive autophagy and related senescence process.
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Huang S, Qi M, Tian T, Dai H, Tang Y, Huang R. Positive BRAFV600E mutation of primary tumor influences radioiodine avidity but not prognosis of papillary thyroid cancer with lung metastases. Front Endocrinol (Lausanne) 2022; 13:959089. [PMID: 36407316 PMCID: PMC9666419 DOI: 10.3389/fendo.2022.959089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 10/17/2022] [Indexed: 12/03/2022] Open
Abstract
PURPOSE This study investigated the relationship between BRAFV600E mutation of the primary tumor and radioiodine avidity in lung metastases (LMs) and then further evaluated the impact of BRAFV600E mutation and radioiodine avidity status on the prognosis of papillary thyroid cancer (PTC) with LMs. METHODS Ninety-four PTC patients with LMs after total thyroidectomy and cervical lymph node dissection between January 2012 and September 2021 were retrospectively included. All patients received BRAFV600E mutation examination of primary tumors and radioactive iodine (RAI) therapy. The therapeutic response was evaluated by Response Evaluation Criteria in Solid Tumors (RECIST) assessments (version 1.1). For patients with target lesions, the response was divided into complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD); for patients without target lesions, the response was divided into CR, non-CR/non-PD, and PD. In therapeutic response, PR and SD were classified as non-CR/non-PD for analysis. The chi-square test and logistic regression were used to analyze the impact factor on PD and mortality. Progression-free survival (PFS) and overall survival (OS) curves were constructed by the Kaplan-Meier method. RESULTS It was found that 21.2% (7/33) of patients with positive BRAFV600E mutation and 62.3% (38/61) of patients with negative BRAFV600E mutation had radioiodine-avid LMs (χ2 = 14.484, p = 0.000). Patients with positive BRAFV600E mutation are more likely to lose radioiodine avidity; the odds ratios (ORs) were 5.323 (95% CI: 1.953-14.514, p = 0.001). Finally, 25 patients had PD, and six patients died; loss of radioiodine avidity was the independent predictor for PD, and the ORs were 10.207 (95% CI: 2.629-39.643, p = 0.001); BRAFV600E mutation status was not correlated with PD (p = 0.602), whether in the radioiodine avidity group (p = 1.000) or the non-radioiodine avidity group (p = 0.867). Similarly, BRAFV600E mutation status was not correlated with mortality; only loss of radioiodine avidity was the unfavorable factor associated with mortality in univariate analyses (p = 0.030). CONCLUSION Patients with LMs of PTC were more likely to lose radioiodine avidity when their primary tumor had positive BRAFV600E mutation; however, only radioiodine avidity and not BRAFV600E mutation status affected the clinical outcome of patients with lung metastatic PTC.
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Affiliation(s)
- Shuhui Huang
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Mengfang Qi
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Tian Tian
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Hongyuan Dai
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Yuan Tang
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, China
- *Correspondence: Rui Huang, ; Yuan Tang,
| | - Rui Huang
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
- *Correspondence: Rui Huang, ; Yuan Tang,
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Kuo CY, Yang PS, Chien MN, Cheng SP. Preoperative Factors Associated with Extrathyroidal Extension in Papillary Thyroid Cancer. Eur Thyroid J 2020; 9:256-262. [PMID: 33088794 PMCID: PMC7548880 DOI: 10.1159/000506474] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 02/11/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Extrathyroidal extension may not be accurately recognized during thyroidectomy and can increase the risk of positive margins and even recurrence. This study aimed to investigate the preoperative factors associated with extrathyroidal extension. METHODS We analyzed 887 patients with papillary thyroid cancer (PTC) who underwent surgery in the period of 2005-2017. Binary logistic regression analyses and generalized additive models were used to identify associations. RESULTS Minimal extrathyroidal extension was present in 233 (26%) patients and advanced extrathyroidal extension was found in 60 (7%) patients. Age, BMI, and tumor size were independent predictors of all or advanced extrathyroidal extension. Among the 493 patients whose BRAF mutation status was available, age (OR = 1.025), BMI (OR = 1.091), tumor size (OR = 1.544), and BRAF V600E mutation (OR = 2.311) were independently associated with extrathyroidal extension. CONCLUSIONS Older age, a greater BMI, a larger tumor size, and presence of the BRAF mutation were predictive of extrathyroidal extension. These factors should be taken into consideration in decision-making before surgery is performed.
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Affiliation(s)
- Chi-Yu Kuo
- Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan
| | - Po-Sheng Yang
- Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan
| | - Ming-Nan Chien
- Division of Endocrinology and Metabolism, Department of Internal Medicine, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan
| | - Shih-Ping Cheng
- Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan
- Department of Pharmacology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- *Shih-Ping Cheng, MD, PhD, Department of Surgery, MacKay Memorial Hospital, 92 Chung-Shan North Rd., Section 2, Taipei 10449 (Taiwan),
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13
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Shi C, Cao J, Shi T, Liang M, Ding C, Lv Y, Zhang W, Li C, Gao W, Wu G, Man J. BRAF V600E mutation, BRAF-activated long non-coding RNA and miR-9 expression in papillary thyroid carcinoma, and their association with clinicopathological features. World J Surg Oncol 2020; 18:145. [PMID: 32593310 PMCID: PMC7321545 DOI: 10.1186/s12957-020-01923-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 06/18/2020] [Indexed: 12/15/2022] Open
Abstract
Background The incidence of thyroid cancer is increasing worldwide. This study investigated the association of B-type RAF kinase (BRAF)V600E mutation status, the expression of BRAF-activated long non-coding RNA (BANCR) and microRNA miR-9, and the clinicopathological features of papillary thyroid carcinoma (PTC). Methods Clinicopathological data for PTC patients (n = 51) diagnosed and treated between 2018 and 2019 were collected. Carcinoma and adjacent normal tissue samples were analyzed for the presence of the BRAFV600E mutation and/or expression of BANCR and miR-9. Results Larger tumor, higher rate of bilateral tumors and multifocality, extracapsular invasion, and lateral lymph node metastasis (LNM) were observed in PTC patients with BRAF V600E mutation. Patients with higher BANCR expression had a higher rate of extracapsular invasion and lateral LNM in carcinoma tissue and a lower frequency of bilateral tumors and multifocality in normal adjacent tissue. Patients with higher miR-9 expression had a lower rate of central and lateral LNM in carcinoma tissue and higher rates of bilateral tumor location and multifocality in normal adjacent tissue. Patients with BRAFV600E mutation have a higher rate of BANCR overexpression and tended to have a lower rate of miR-9 overexpression (P = 0.057), and a negative association was observed between BANCR and miR-9 expression in carcinoma tissue. Conclusions BRAFV600E mutation and the BANCR and miR-9 expression were closely associated with the tumor size, bilateral tumor location, multifocality, extracapsular invasion, and lateral LNM. PTC patients with these clinicopathological characteristics, BRAFV600E mutation, and high BANCR expression and low miR-9 expression needed earlier surgical treatment and are recommended for total thyroidectomy in primary surgery for reducing the risk of recurrence. These findings provide new insight into the molecular basis for PTC and can inform strategies for the management of PTC.
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Affiliation(s)
- Chenlei Shi
- The Fourth Department of General Surgery, the Second Affiliated Hospital, Harbin Medical University, 246 Xuefu Road, Harbin, 150001, Heilongjiang Province, China
| | - Jia Cao
- The Department of Head and Neck Surgery, General Hospital of Heilongjiang Province Land Reclamation Bureau, Harbin, 150088, Heilongjiang Province, China
| | - Tiefeng Shi
- The Fourth Department of General Surgery, the Second Affiliated Hospital, Harbin Medical University, 246 Xuefu Road, Harbin, 150001, Heilongjiang Province, China.
| | - Meihua Liang
- The Fourth Department of General Surgery, the Second Affiliated Hospital, Harbin Medical University, 246 Xuefu Road, Harbin, 150001, Heilongjiang Province, China
| | - Chao Ding
- The Fourth Department of General Surgery, the Second Affiliated Hospital, Harbin Medical University, 246 Xuefu Road, Harbin, 150001, Heilongjiang Province, China
| | - Yichen Lv
- The Fourth Department of General Surgery, the Second Affiliated Hospital, Harbin Medical University, 246 Xuefu Road, Harbin, 150001, Heilongjiang Province, China
| | - Weifeng Zhang
- The Fourth Department of General Surgery, the Second Affiliated Hospital, Harbin Medical University, 246 Xuefu Road, Harbin, 150001, Heilongjiang Province, China
| | - Chuanle Li
- The Fourth Department of General Surgery, the Second Affiliated Hospital, Harbin Medical University, 246 Xuefu Road, Harbin, 150001, Heilongjiang Province, China
| | - Wenchao Gao
- The Fourth Department of General Surgery, Harbin First Hospital Affiliated to Harbin Institute of Technology, Harbin, 150010, Heilongjiang Province, China
| | - Gang Wu
- The Fourth Department of General Surgery, the Second Affiliated Hospital, Harbin Medical University, 246 Xuefu Road, Harbin, 150001, Heilongjiang Province, China
| | - Jianting Man
- The Fourth Department of General Surgery, the Second Affiliated Hospital, Harbin Medical University, 246 Xuefu Road, Harbin, 150001, Heilongjiang Province, China
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14
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Tran TV, Dang KX, Pham QH, Nguyen UD, Trinh NTT, Hoang LV, Ho SA, Nguyen BV, Nguyen DT, Trinh DT, Tran DN, Orpana A, Stenman UH, Stenman J, Ho TH. Evaluation of the expression levels of BRAF V600E mRNA in primary tumors of thyroid cancer using an ultrasensitive mutation assay. BMC Cancer 2020; 20:368. [PMID: 32357861 PMCID: PMC7195771 DOI: 10.1186/s12885-020-06862-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 04/14/2020] [Indexed: 12/05/2022] Open
Abstract
Background The BRAFV600E gene encodes for the mutant BRAFV600E protein, which triggers downstream oncogenic signaling in thyroid cancer. Since most currently available methods have focused on detecting BRAFV600E mutations in tumor DNA, there is limited information about the level of BRAFV600E mRNA in primary tumors of thyroid cancer, and the diagnostic relevance of these RNA mutations is not known. Methods Sixty-two patients with thyroid cancer and non-malignant thyroid disease were included in the study. Armed with an ultrasensitive technique for mRNA-based mutation analysis based on a two step RT-qPCR method, we analysed the expression levels of the mutated BRAFV600E mRNA in formalin-fixed paraffin-embedded samples of thyroid tissues. Sanger sequencing for detection of BRAFV600E DNA was performed in parallel for comparison and normalization of BRAFV600E mRNA expression levels. Results The mRNA-based mutation detection assay enables detection of the BRAFV600E mRNA transcripts in a 10,000-fold excess of wildtype BRAF counterparts. While BRAFV600E mutations could be detected by Sanger sequencing in 13 out of 32 malignant thyroid cancer FFPE tissue samples, the mRNA-based assay detected mutations in additionally 5 cases, improving the detection rate from 40.6 to 56.3%. Furthermore, we observed a surprisingly large, 3-log variability, in the expression level of the BRAFV600E mRNA in FFPE samples of thyroid cancer tissue. Conclusions The expression levels of BRAFV600E mRNA was characterized in the primary tumors of thyroid cancer using an ultrasensitive mRNA-based mutation assay. Our data inspires further studies on the prognostic and diagnostic relevance of the BRAFV600E mRNA levels as a molecular biomarker for the diagnosis and monitoring of various genetic and malignant diseases.
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Affiliation(s)
- Tien Viet Tran
- 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Kien Xuan Dang
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Quynh Huong Pham
- Department of Genomics and Cytogenetics, Institute of Biomedicine and Pharmacy (IBP), Vietnam Military Medical University, 222 Phung Hung street, Ha Dong district, Hanoi, Vietnam
| | - Ung Dinh Nguyen
- Department of Genomics and Cytogenetics, Institute of Biomedicine and Pharmacy (IBP), Vietnam Military Medical University, 222 Phung Hung street, Ha Dong district, Hanoi, Vietnam
| | - Nhung Thi Trang Trinh
- Department of Genomics and Cytogenetics, Institute of Biomedicine and Pharmacy (IBP), Vietnam Military Medical University, 222 Phung Hung street, Ha Dong district, Hanoi, Vietnam
| | - Luong Van Hoang
- Institute of Biomedicine and Pharmacy (IBP), Vietnam Military Medical University, Hanoi, Vietnam
| | - Son Anh Ho
- Institute of Biomedicine and Pharmacy (IBP), Vietnam Military Medical University, Hanoi, Vietnam
| | - Ba Van Nguyen
- Oncology Centre, 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Duc Trong Nguyen
- School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Dung Tuan Trinh
- Pathology Department, 108 Military Central Hospital, Hanoi, Vietnam
| | - Dung Ngoc Tran
- Department of Pathology, 103 Military Hospital, Vietnam Military Medical University, Hanoi, Vietnam
| | - Arto Orpana
- Laboratory of Genetics, HUSLAB, Helsinki University Central Hospital, Helsinki, Finland
| | - Ulf-Håkan Stenman
- Department of Clinical Chemistry, Medicum, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Jakob Stenman
- Minerva Foundation Institute for Medical Research, Helsinki, Finland.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Tho Huu Ho
- Minerva Foundation Institute for Medical Research, Helsinki, Finland. .,Department of Genomics and Cytogenetics, Institute of Biomedicine and Pharmacy (IBP), Vietnam Military Medical University, 222 Phung Hung street, Ha Dong district, Hanoi, Vietnam. .,Department of Medical Microbiology, 103 Military Hospital, Vietnam Medical University, Hanoi, Vietnam.
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15
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Maffini F, Lorenzini D, Lepanto D, De Fiori E, Fumagalli C, Rappa A, Tagliabue M, Barberis M. A case of Warthin-like papillary thyroid carcinoma with diffuse sclerosing stroma and a novel RET mutation: a new entity or a combined tumour? Ecancermedicalscience 2019; 13:965. [PMID: 31921336 PMCID: PMC6834387 DOI: 10.3332/ecancer.2019.965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Indexed: 01/11/2023] Open
Abstract
Activating mutations of the RET gene have been described for both papillary (chromosomal rearrangement) and medullary (missense mutations) thyroid carcinomas. Here, we describe a case of a Warthin-like variant of papillary thyroid carcinoma displaying some morphological aspects that mimic the diffuse sclerosing variant. The tumour harboured BRAF V600E mutation and a novel germline point mutation in the RET gene, with unknown clinical and pathological meaning.
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Affiliation(s)
- Fausto Maffini
- Department of Pathology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy.,These authors contributed equally to writing this article
| | - Daniele Lorenzini
- University of Milan School of Medicine, Via Ripamonti 435, 20141 Milan, Italy.,These authors contributed equally to writing this article
| | - Daniela Lepanto
- Department of Pathology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
| | - Elvio De Fiori
- Department of Radiology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
| | - Caterina Fumagalli
- Department of Pathology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
| | - Alessandra Rappa
- Department of Pathology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
| | - Marta Tagliabue
- Division of Otolaryngology and Head and Neck Surgery, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
| | - Massimo Barberis
- Department of Pathology, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy
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16
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Estrada-Flórez AP, Bohórquez ME, Vélez A, Duque CS, Donado JH, Mateus G, Panqueba-Tarazona C, Polanco-Echeverry G, Sahasrabudhe R, Echeverry M, Carvajal-Carmona LG. BRAF and TERT mutations in papillary thyroid cancer patients of Latino ancestry. Endocr Connect 2019; 8:1310-1317. [PMID: 31454788 PMCID: PMC6765322 DOI: 10.1530/ec-19-0376] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 08/22/2019] [Indexed: 12/13/2022]
Abstract
Papillary thyroid cancer (PTC) is the second most commonly diagnosed malignancy in U.S. Latinas and in Colombian women. Studies in non-Latinos indicate that BRAF and TERT mutations are PTC prognostic markers. This study aimed to determine the prevalence and clinical associations of BRAF and TERT mutations in PTC Latino patients from Colombia. We analyzed mutations of BRAF (V600E) and TERT promoter (C228T, C250T) in tumor DNA from 141 patients (75 with classical variant PTC, CVPTC; 66 with follicular variant PTC, FVPTC) recruited through a multi-center study. Associations between mutations and clinical variables were evaluated with Fisher exact tests. Survival was evaluated with Kaplan-Meier plots. Double-mutant tumors (BRAF+/TERT+, n = 14 patients) were more common in CVPTC (P = 0.02). Relative to patients without mutations (n = 48), double mutations were more common in patients with large tumors (P = 0.03), lymph node metastasis (P = 0.01), extra-thyroid extension (P = 0.03), and advanced stage (P = 6.0 × 10-5). In older patients, TERT mutations were more frequent (mean age 51 years vs 45 years for wild type TERT, P = 0.04) and survival was lower (HR = 1.20; P = 0.017); however, given the small sample size, the decrease in survival was not statically significant between genotypes. Comparisons with published data in US whites revealed that Colombian patients had a higher prevalence of severe pathological features and of double-mutant tumors (10 vs 6%, P = 0.001). Mutations in both oncogenes show prognostic associations in Latinos from Colombia. Our study is important to advance Latino PTC precision medicine and replicates previous prognostic associations between BRAF and TERT in this population.
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Affiliation(s)
- Ana P Estrada-Flórez
- Genome Center and Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, California, USA
- Grupo de Citogenética, Filogenia y Evolución de Poblaciones, Facultad de Ciencias y Facultad de Ciencias de la Salud, Universidad del Tolima, Ibagué, Tolima, Colombia
- Facultad de Ciencias para la Salud, Universidad de Caldas, Manizales, Caldas, Colombia
| | - Mabel E Bohórquez
- Grupo de Citogenética, Filogenia y Evolución de Poblaciones, Facultad de Ciencias y Facultad de Ciencias de la Salud, Universidad del Tolima, Ibagué, Tolima, Colombia
| | - Alejandro Vélez
- Dinamica IPS, Medellín, Antioquia, Colombia
- Hospital Pablo Tobón Uribe, Medellín, Antioquia, Colombia
| | - Carlos S Duque
- Hospital Pablo Tobón Uribe, Medellín, Antioquia, Colombia
| | - Jorge H Donado
- Hospital Pablo Tobón Uribe, Medellín, Antioquia, Colombia
| | - Gilbert Mateus
- Hospital Federico Lleras Acosta, Ibagué, Tolima, Colombia
| | | | - Guadalupe Polanco-Echeverry
- Genome Center and Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, California, USA
| | - Ruta Sahasrabudhe
- Genome Center and Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, California, USA
| | - Magdalena Echeverry
- Grupo de Citogenética, Filogenia y Evolución de Poblaciones, Facultad de Ciencias y Facultad de Ciencias de la Salud, Universidad del Tolima, Ibagué, Tolima, Colombia
| | - Luis G Carvajal-Carmona
- Genome Center and Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, California, USA
- Dinamica IPS, Medellín, Antioquia, Colombia
- University of California Davis Comprehensive Cancer Center, Sacramento, California, USA
- Fundación de Genética y Genómica, Medellín, Antioquia, Colombia
- Correspondence should be addressed to L G Carvajal-Carmona:
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17
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Yan C, Huang M, Li X, Wang T, Ling R. Relationship between BRAF V600E and clinical features in papillary thyroid carcinoma. Endocr Connect 2019; 8:988-996. [PMID: 31252408 PMCID: PMC6652244 DOI: 10.1530/ec-19-0246] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 06/17/2019] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate the mutant status of BRAF gene and analyze its relationship to epidemiological risk factors and clinical outcomes among patients with papillary thyroid cancer (PTC) in the largest, single-institution Chinese cohort to date. METHODS The medical records of 2048 PTC patients were reviewed in this retrospective study. Single-factor and multiple logistic regression analyses were applied to identify risk factors for BRAF V600E mutation. Survival outcomes including distant metastatic and persistent or recurrent PTC were examined, with a mean follow-up time of 23.4 (5-47) months. RESULTS The BRAF V600E mutation was present in 83.7% of patients (1715 of 2048). Correlation was found between BRAF V600E mutation and several epidemiological features, including age, concomitant hypertension and Hashimoto thyroiditis (HT). For the clinicopathological features, BRAF V600E was significantly associated with bilateral multifocality (odds ratio (OR) 1.233, 95% confidence interval (CI) 1.063-1.431, P < 0.01) and less lateral lymph node metastases (OR 0.496, 95% CI 0.357-0.689, P < 0.01). Smaller tumor size and advanced disease stage were significant in single-factor analyses but became insignificant after multivariate adjustment. No association was found between BRAF V600E mutation and extrathyroidal invasion, distant metastatic and disease persistence or recurrence. CONCLUSION Part of epidemiological features are independent risk or protective factors for BRAF V600E mutation. The presence of BRAF V600E mutation is not an aggressive prognosis on poor clinical outcomes in PTC. However, the high prevalence of BRAF V600E may provide guidance for surgery strategy and opportunity for targeted treatment in recurrent and advanced stage disease.
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Affiliation(s)
- Changjiao Yan
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Meiling Huang
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Xin Li
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Ting Wang
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
- Correspondence should be addressed to R Ling or T Wang: or
| | - Rui Ling
- Department of Thyroid, Breast and Vascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
- Correspondence should be addressed to R Ling or T Wang: or
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18
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Jeon MJ, Chun SM, Lee JY, Choi KW, Kim D, Kim TY, Jang SJ, Kim WB, Shong YK, Song DE, Kim WG. Mutational profile of papillary thyroid microcarcinoma with extensive lymph node metastasis. Endocrine 2019; 64:130-138. [PMID: 30645724 DOI: 10.1007/s12020-019-01842-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 01/04/2019] [Indexed: 12/22/2022]
Abstract
PURPOSE Papillary thyroid microcarcinoma (PTMC) has excellent outcomes, but extensive lymph node (LN) metastasis can be associated with fatal outcomes. We evaluated the mutational profiles of primary tumors and their metastatic LNs of PTMCs with extensive lateral cervical LN metastases. METHODS Formalin-fixed, paraffin-embedded archival samples from 16 sets of normal thyroid tissue, the primary PTMC, and the largest metastatic LN were used for targeted sequencing. RESULTS A total of seven somatic variants were confirmed in the PTMCs compared to the normal tissue. The BRAFV600E mutation was the most common and seen in 12 primary tumors (75%) and 11 metastatic LNs (69%). A nonsense mutation in AR and an in-frame deletion in ACVR2A were detected in one primary tumor and its metastatic LN (6%). Missense mutations in KMT2A, RAF1, and ROS1 were detected in one primary tumor (3%). A frameshift deletion mutation in JAK2 was detected in a metastatic LN (3%). In PTMCs without the BRAF mutation, an ALK and RET rearrangement (one PTMC and its metastatic LN, 6%) was detected. In one patient, the BRAF mutation was detected in the primary tumor, but only a RET rearrangement was detected in its metastatic LN. No mutations were detected in two patients. CONCLUSION The mutational frequency of PTMCs was really low, even in those with extensive LN metastasis. The mutational status of the primary tumor and its metastatic LNs were not significantly different, and this suggests a minor role for genetic alterations in the process of LN metastasis in PTMC.
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Affiliation(s)
- Min Ji Jeon
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea
| | - Sung Min Chun
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea
- Center for Cancer Genome Discovery, Asan Institute for Life Science, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea
| | - Ji-Young Lee
- Center for Cancer Genome Discovery, Asan Institute for Life Science, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea
| | - Kyeong Woon Choi
- Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea
| | - Deokhoon Kim
- Center for Cancer Genome Discovery, Asan Institute for Life Science, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea
| | - Tae Yong Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea
| | - Se Jin Jang
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea
| | - Won Bae Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea
| | - Young Kee Shong
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea
| | - Dong Eun Song
- Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea.
| | - Won Gu Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Korea.
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19
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Pessôa-Pereira D, Medeiros MFDS, Lima VMS, da Silva JC, Cerqueira TLDO, da Silva IC, Fonseca LE, Sampaio LJL, de Lima CRA, Ramos HE. Association between BRAF (V600E) mutation and clinicopathological features of papillary thyroid carcinoma: a Brazilian single-centre case series. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2019; 63:97-106. [PMID: 30916170 PMCID: PMC10522140 DOI: 10.20945/2359-3997000000120] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 01/14/2019] [Indexed: 12/09/2022]
Abstract
OBJECTIVES We aimed to investigate the prevalence of the BRAF (V600E) mutation in consecutive cases of papillary thyroid carcinoma (PTC) in patients diagnosed and treated at the Hospital Sao Rafael (Salvador, BA, Brazil) and evaluate its association with clinical and pathological characteristics of PTC. SUBJECTS AND METHODS We retrospectively enrolled in the study a total of 43 consecutive PTC patients who underwent total thyroidectomy. We performed DNA extraction from formalin-fixed paraffin-embedded (FFPE) tumour tissue samples. Polymerase chain reaction (PCR) and direct sequencing were used to determine BRAF (V600E) mutation status. Univariate and multivariate logistic regression analyses were employed to identify independent associations. RESULTS The prevalence of BRAF (V600E) mutation was 65.1% (28/43). A high frequency of older patients (p value: 0.004) was observed among the BRAF-mutated PTC group and, in contrast, a low frequency of concurrent Hashimoto's thyroiditis (HT) (p value: 0.011) was noted. Multivariate analysis confirmed that older age (OR: 1.15; 95% CI: 1.00 - 1.33; p value: 0.047) and HT (OR: 0.05; 95% CI: 0.006-0.40; p value: 0.005) were independent factors associated with BRAF (V600E) mutation. CONCLUSION We found a high prevalence of BRAF (V600E) mutation in PTC cases. Older age and no concurrent HT were independently associated with BRAF (V600E) mutation.
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Affiliation(s)
- Danielle Pessôa-Pereira
- Universidade Federal da BahiaUniversidade Federal da BahiaInstituto de Saúde e CiênciaLaboratório de Estudo da TireoideSalvadorBABrasilDepartamento de Biorregulação, Laboratório de Estudo da Tireoide, Instituto de Saúde e Ciência, Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil
| | - Mateus Fernandes da Silva Medeiros
- Universidade Federal da BahiaUniversidade Federal da BahiaInstituto de Saúde e CiênciaLaboratório de Estudo da TireoideSalvadorBABrasilDepartamento de Biorregulação, Laboratório de Estudo da Tireoide, Instituto de Saúde e Ciência, Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil
| | - Virna Mendonça Sampaio Lima
- Universidade Federal da BahiaUniversidade Federal da BahiaInstituto de Saúde e CiênciaLaboratório de Estudo da TireoideSalvadorBABrasilDepartamento de Biorregulação, Laboratório de Estudo da Tireoide, Instituto de Saúde e Ciência, Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil
| | - Joaquim Custódio da Silva
- Universidade Federal da BahiaUniversidade Federal da BahiaInstituto de Saúde e CiênciaLaboratório de Estudo da TireoideSalvadorBABrasilDepartamento de Biorregulação, Laboratório de Estudo da Tireoide, Instituto de Saúde e Ciência, Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil
| | - Taíse Lima de Oliveira Cerqueira
- Universidade Federal da BahiaUniversidade Federal da BahiaInstituto de Saúde e CiênciaLaboratório de Estudo da TireoideSalvadorBABrasilDepartamento de Biorregulação, Laboratório de Estudo da Tireoide, Instituto de Saúde e Ciência, Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil
| | - Igor Campos da Silva
- Hospital São RafaelDepartamento de Anatomia Patológica e CitopatologiaSalvadorBABrasilDepartamento de Anatomia Patológica e Citopatologia, Hospital São Rafael, Salvador, BA, Brasil
| | - Luciano Espinheira Fonseca
- Hospital São RafaelDepartamento de Anatomia Patológica e CitopatologiaSalvadorBABrasilDepartamento de Anatomia Patológica e Citopatologia, Hospital São Rafael, Salvador, BA, Brasil
- Universidade Federal da BahiaUniversidade Federal da BahiaFaculdade de Medicina da BahiaDepartamento de Anatomia Patológica e Medicina LegalSalvadorBABrasilDepartamento de Anatomia Patológica e Medicina Legal, Faculdade de Medicina da Bahia, Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil
| | - Luiz José Lobão Sampaio
- Hospital São RafaelDepartamento de Medicina NuclearSalvadorBABrasilDepartamento de Medicina Nuclear, Hospital São Rafael, Salvador, BA, Brasil
| | - Cláudio Rogério Alves de Lima
- Hospital São RafaelDepartamento de Cirurgia de Cabeça e PescoçoSalvadorBABrasilDepartamento de Cirurgia de Cabeça e Pescoço, Hospital São Rafael, Salvador, BA, Brasil
| | - Helton Estrela Ramos
- Universidade Federal da BahiaUniversidade Federal da BahiaInstituto de Saúde e CiênciaLaboratório de Estudo da TireoideSalvadorBABrasilDepartamento de Biorregulação, Laboratório de Estudo da Tireoide, Instituto de Saúde e Ciência, Universidade Federal da Bahia (UFBA), Salvador, BA, Brasil
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de Biase D, Torricelli F, Ragazzi M, Donati B, Kuhn E, Visani M, Acquaviva G, Pession A, Tallini G, Piana S, Ciarrocchi A. Not the same thing: metastatic PTCs have a different background than ATCs. Endocr Connect 2018; 7:1370-1379. [PMID: 30400028 PMCID: PMC6280609 DOI: 10.1530/ec-18-0386] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 10/30/2018] [Indexed: 02/05/2023]
Abstract
Anaplastic thyroid cancer (ATC) is a rare but highly aggressive form of thyroid cancer. By contrast, differentiated papillary thyroid cancer (PTC) only rarely behave aggressively and develop distant metastasis. Whether distantly metastatic PTC (DM-PTC) and ATC share a common genetic background is still to be defined. We used next-generation sequencing (NGS) to explore the genetic background of a cohort of ATC and DM-PTC and a group of well-differentiated PTCs that did not developed distant metastasis as control (ctrl-PTC). A panel of 128 amplicons within 21 thyroid cancer-related genes was analyzed in a set of 151 thyroid cancer samples including 66 ATCs and DM-PTCs. We showed that the ATC/DM-PTC group had an overall mutational load higher than ctrl-PTCs and that ATCs and DM-PTCs are characterized by a different genetic background, with the exception of mutations in the TERT promoter that were overrepresented in both ATCs (61.1%) and DM-PTCs (48.2%) vs non-aggressive ctrl-PTCs (7.6%). In ATCs, TERT promoter mutations were frequently associated with TP53 mutations, while in the DM-PTCs no significant co-occurrence was observed. No significant association of MED12 mutations with aggressiveness of thyroid cancer was observed in our analysis. Finally, correlation analysis showed that increasing number of mutations negatively impact on patient overall survival also within the ATC and DM-PTC group. In conclusions, overall our analysis further highlights the relevance of TERT promoter mutations in driving aggressiveness and provides new pieces of information in the definition of aggressiveness evolution of thyroid cancer lesions.
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Affiliation(s)
- Dario de Biase
- Department of Pharmacy and Biotechnology (Dipartimento di Farmacia e Biotecnologie) – Molecular Diagnostic Unit, Azienda USL di Bologna, University of Bologna, Bologna, Italy
- Correspondence should be addressed to A Ciarrocchi or D de Biase: or
| | - Federica Torricelli
- Laboratory of Translational Research, Azienda Unità Sanitaria Locale AUSL-IRCCS, Reggio Emilia, Italy
| | - Moira Ragazzi
- Pathology Unit, Azienda Unità Sanitaria Locale AUSL-IRCCS, Reggio Emilia, Italy
| | - Benedetta Donati
- Laboratory of Translational Research, Azienda Unità Sanitaria Locale AUSL-IRCCS, Reggio Emilia, Italy
| | - Elisabetta Kuhn
- Pathology Unit, Azienda Unità Sanitaria Locale AUSL-IRCCS, Reggio Emilia, Italy
| | - Michela Visani
- Department of Medicine (Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale) – Molecular Diagnostic Unit, Azienda USL di Bologna, University of Bologna School of Medicine, Bologna, Italy
| | - Giorgia Acquaviva
- Department of Medicine (Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale) – Molecular Diagnostic Unit, Azienda USL di Bologna, University of Bologna School of Medicine, Bologna, Italy
| | - Annalisa Pession
- Department of Pharmacy and Biotechnology (Dipartimento di Farmacia e Biotecnologie) – Molecular Diagnostic Unit, Azienda USL di Bologna, University of Bologna, Bologna, Italy
| | - Giovanni Tallini
- Department of Medicine (Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale) – Molecular Diagnostic Unit, Azienda USL di Bologna, University of Bologna School of Medicine, Bologna, Italy
| | - Simonetta Piana
- Pathology Unit, Azienda Unità Sanitaria Locale AUSL-IRCCS, Reggio Emilia, Italy
| | - Alessia Ciarrocchi
- Laboratory of Translational Research, Azienda Unità Sanitaria Locale AUSL-IRCCS, Reggio Emilia, Italy
- Correspondence should be addressed to A Ciarrocchi or D de Biase: or
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Gallo C, Fragliasso V, Donati B, Torricelli F, Tameni A, Piana S, Ciarrocchi A. The bHLH transcription factor DEC1 promotes thyroid cancer aggressiveness by the interplay with NOTCH1. Cell Death Dis 2018; 9:871. [PMID: 30158530 PMCID: PMC6115386 DOI: 10.1038/s41419-018-0933-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 07/30/2018] [Accepted: 08/01/2018] [Indexed: 02/06/2023]
Abstract
Aberrant re-activation of transcription factors occurs frequently in cancer. Recently, we found the basic helix-loop-helix transcription factors DEC1 and DEC2 significantly up-regulated in a model of highly aggressive thyroid cancer, raising the hypothesis that these factors might be part of the program driving progression of these tumors. Here, we investigated for the first time the function of DEC1 and DEC2 in thyroid cancer. Using both gain- and loss-of-function approaches, we showed that DEC1 more than DEC2 sustains progression of thyroid cancer by promoting cell growth and invasiveness. We demonstrated that DEC1 controls NOTCH1 expression and that the interplay with the NOTCH pathway is relevant for DEC1 function in thyroid cancer. We confirmed this observation in vivo showing that DEC1 expression is a specific feature of tumor cells, that this transcription factor is significantly over-expressed in all major thyroid cancer histotypes and that its expression correlated with NOTCH1 in these tumors. Finally, we performed RNA-sequencing to define the DEC1-associated gene expression profile in thyroid cancer cells and we discovered that DEC1 drives the expression of many cell cycle-related genes, uncovering a potential new function for this transcription factor in cancer.
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Affiliation(s)
- Cristina Gallo
- Laboratory of Translational Research, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Valentina Fragliasso
- Laboratory of Translational Research, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Benedetta Donati
- Laboratory of Translational Research, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Federica Torricelli
- Laboratory of Translational Research, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Annalisa Tameni
- Laboratory of Translational Research, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Simonetta Piana
- Pathology Unit, Department of Oncology, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, 42123, Italy
| | - Alessia Ciarrocchi
- Laboratory of Translational Research, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, 42123, Italy.
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Targeted next generation sequencing identifies somatic mutations and gene fusions in papillary thyroid carcinoma. Oncotarget 2018; 8:45784-45792. [PMID: 28507274 PMCID: PMC5542227 DOI: 10.18632/oncotarget.17412] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 04/04/2017] [Indexed: 12/12/2022] Open
Abstract
138 papillary thyroid carcinoma (PTC) samples were assessed for somatic mutation profile and fusion genes by targeted resequencing using a cancer panel (ThyGenCapTM) targeting 244 cancer-related genes and 20 potential fusion genes. At least one genetic alteration (including mutations and fusion genes) was observed in 118/138 (85.5%) samples. The most frequently mutated gene was BRAF V600E (57.2%). Moreover, we identified 11 fusion genes including eight previously reported ones and three novel fusion genes, UEVLD-RET, OSBPL9-BRAF, and SQSTM1-NTRK3. Alterations affecting the mitogen-activated protein kinase (MAPK) signaling pathway components were seen in 69.6% of the PTC cases and all of these driver mutations were mutually exclusive. Univariate analysis ascertained that the fusion genes were strongly associated with distinct clinicopathological characteristics, such as young age, local invasion, extensive metastasis, and disease stage. In conclusion, our approach facilitated simultaneous high-throughput detection of gene fusions and somatic mutations in PTC samples.
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BRAF 1799T>A Mutation Frequency in Mexican Mestizo Patients with Papillary Thyroid Cancer. BIOMED RESEARCH INTERNATIONAL 2018; 2018:2582179. [PMID: 29808165 PMCID: PMC5902102 DOI: 10.1155/2018/2582179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Revised: 02/19/2018] [Accepted: 02/22/2018] [Indexed: 12/01/2022]
Abstract
Thyroid cancer is the most frequent endocrine malignancy, and its incidence and prevalence are increasing worldwide. Despite its generally good prognosis, the observed mortality rates are higher in the less-developed regions. This indicates that timely diagnosis and appropriate initial management of this disease are important to achieve a positive outcome. We performed an observational study in order to describe the frequency of the BRAF 1799T>A mutation in Mexican mestizo patients with thyroid nodules, a scarcely studied ethnic group with large populations. Competitive allele-specific Taqman PCR was performed in 147 samples of thyroid tissue DNA obtained from patients histologically diagnosed with papillary thyroid cancer (PTC), colloid goiters, and follicular adenomas. The BRAF 1799T>A mutation frequency was 61.1% in PTC samples (p = 4.99 × 10−11). Potential diagnostic values were as follows: sensitivity, 61.1%; specificity, 96%; PPV, 94.2%; NPV, 69.5%; accuracy, 77.9%. Taking into account the fact that this mutation is not frequently found in cytologically indeterminate nodules, we suggest that the BRAF mutational analysis should be implemented in the clinical setting along with other diagnostic criteria such as USG, in order to contribute to diagnosis and to surgical decision-making during the initial management of thyroid nodules in Mexican public hospitals.
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Moore MD, Panjwani S, Gray KD, Finnerty BM, Zarnegar R, Fahey TJ. The role of molecular diagnostic testing in the management of thyroid nodules. Expert Rev Mol Diagn 2017; 17:567-576. [PMID: 28423960 DOI: 10.1080/14737159.2017.1321987] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Fine needle aspiration (FNA) with cytologic examination remains the standard of care for investigation of thyroid nodules. However, as many as 30% of FNA samples are cytologically indeterminate for malignancy, which confounds clinical management. To reduce the burden of repeat diagnostic testing and unnecessary surgery, there has been extensive investigation into molecular markers that can be detected on FNA specimens to more accurately stratify a patient's risk of malignancy. Areas covered: In this review, the authors discuss recent evidence and progress in molecular markers used in the diagnosis of thyroid cancer highlighting somatic gene alterations, molecular technologies and microRNA analysis. Expert commentary: The goal of molecular markers is to improve diagnostic accuracy and aid clinicians in the preoperative management of thyroid lesions. Modalities such as direct mutation analysis, mRNA gene expression profiling, next-generation sequencing, and miRNA expression profiling have been explored to improve the diagnostic accuracy of thyroid nodule FNA. Although no perfect test has been discovered, molecular diagnostic testing has revolutionized the management of thyroid nodules.
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Affiliation(s)
- Maureen D Moore
- a Department of Surgery , New York Presbyterian-Weill Cornell Medicine , New York , NY , USA
| | - Suraj Panjwani
- a Department of Surgery , New York Presbyterian-Weill Cornell Medicine , New York , NY , USA
| | - Katherine D Gray
- a Department of Surgery , New York Presbyterian-Weill Cornell Medicine , New York , NY , USA
| | - Brendan M Finnerty
- a Department of Surgery , New York Presbyterian-Weill Cornell Medicine , New York , NY , USA
| | - Rasa Zarnegar
- a Department of Surgery , New York Presbyterian-Weill Cornell Medicine , New York , NY , USA
| | - Thomas J Fahey
- a Department of Surgery , New York Presbyterian-Weill Cornell Medicine , New York , NY , USA
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Chien MN, Yang PS, Lee JJ, Wang TY, Hsu YC, Cheng SP. Recurrence-associated genes in papillary thyroid cancer: An analysis of data from The Cancer Genome Atlas. Surgery 2017; 161:1642-1650. [PMID: 28237646 DOI: 10.1016/j.surg.2016.12.039] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 12/18/2016] [Accepted: 12/29/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Recurrence of papillary thyroid cancer is not uncommon, but incorporating clinicopathologic parameters to predict recurrence is suboptimal. The aim of this study was to identify systemically recurrence-associated genes using The Cancer Genome Atlas RNA sequencing database. METHODS A total of 504 patients with transcriptome sequencing data of the primary neoplasm were included in this study. High and low levels of expression of each gene were defined by median splits. Differences in recurrence-free survival were compared using Kaplan-Meier curves and log-rank tests. Recurrence-associated genes were subjected to functional enrichment analyses with Kyoto Encyclopedia of Genes and Genomes annotation databases and Ingenuity Pathway Analysis. RESULTS We found that 1,807 genes were associated with recurrence-free survival. There were 676 genes of which high expression was associated with a greater risk of recurrence. These genes were enriched in pathways involved in cell cycle regulation and DNA repair. Among 1,131 genes of which low expression was associated with recurrence, Kyoto Encyclopedia of Genes and Genomes-annotated functions were metabolism, calcium signaling, glycan biosynthesis, and the Notch signaling pathway. Canonical pathways identified by Ingenuity Pathway Analysis included RXR function, nitric oxide signaling, interleukin-8 signaling, and nutrient sensing. In addition, low expression of the majority of thyroid differentiation genes was associated with a significantly less recurrence-free survival. CONCLUSION Upregulation of cell cycle-regulating and DNA repair genes appears to have a negative impact on recurrence-free survival in patients with papillary thyroid cancer. Furthermore, recurrence is associated with thyroid dedifferentiation.
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Affiliation(s)
- Ming-Nan Chien
- Division of Endocrinology and Metabolism, Department of Internal Medicine, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan
| | - Po-Sheng Yang
- Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan; Graduate Institute of Medical Sciences and Department of Pharmacology, Taipei Medical University, Taipei, Taiwan
| | - Jie-Jen Lee
- Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan; Graduate Institute of Medical Sciences and Department of Pharmacology, Taipei Medical University, Taipei, Taiwan
| | - Tao-Yeuan Wang
- Department of Pathology, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan
| | - Yi-Chiung Hsu
- Department of Biomedical Sciences and Engineering, National Central University, Taoyuan City, Taiwan; Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Shih-Ping Cheng
- Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei, Taiwan; Graduate Institute of Medical Sciences and Department of Pharmacology, Taipei Medical University, Taipei, Taiwan.
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Gulec S. The Art and Science of Thyroid Surgery in the Age of Genomics: 100 years after Theodor Kocher. Mol Imaging Radionucl Ther 2017; 26:1-9. [PMID: 28117284 PMCID: PMC5283713 DOI: 10.4274/2017.26.suppl.01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Cancer is a disorder of the genome. The thyroid cancer genome is being decoded. Recent studies have identified a mutation or a genetic alteration in 95% of thyroid cancers. The National Cancer Institute initiated the Cancer Genome Atlas project in 2006 to catalogue genetic mutations associated with cancer, using genome sequencing and bioinformatics. The project has expanded to carry out genomic characterization and sequence analysis of thyroid cancer. The concept of risk stratification based on traditional parameters will soon vacate their role for clear molecular markers of non-invasive/focal, invasive/metastatic and systemic stages/phases of neoplastic disorder. A refined classification scheme based on genomics and its phenotypic expressions will accurately reflect the biologic differences between the different morphologic definitions we use today. Tumor differentiation/de-differentiation, and clinical behavior of an individual cancer will be defined by molecular markers, in addition to standard morpho-pathology. Empiricism in science of medicine and surgery has acquired a new method for testing the appropriate treatment for individual patients; that is molecular pathology, governed by genomics. The technology is present and rapidly evolving. The surgeons will determine the extent of interventions with molecular evidence and guidance.
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Affiliation(s)
- Seza Gulec
- Florida International University Herbert Wertheim College of Medicine, Departments of Surgery and Nuclear Medicine, Miami, USA, Phone: (786) 693 08 21, E-mail:
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Papillary thyroid carcinoma with nodular fasciitis-like stroma and β-catenin mutations should be renamed papillary thyroid carcinoma with desmoid-type fibromatosis. Mod Pathol 2017; 30:236-245. [PMID: 27713418 DOI: 10.1038/modpathol.2016.173] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 08/24/2016] [Accepted: 08/26/2016] [Indexed: 12/22/2022]
Abstract
Various histological variants of papillary thyroid carcinoma have been reported, some with clinical implications, some with peculiar, sometimes misleading morphologies. One of these rare and poorly characterized variants is papillary thyroid carcinoma with nodular fasciitis-like stroma, of which fewer than 30 cases have been documented, mostly as isolated reports. It is a dual tumor comprising a malignant epithelial proliferation that harbors typical features of conventional papillary thyroid carcinoma, admixed with a prominent mesenchymal proliferation resembling nodular fasciitis or fibromatosis. Thus, the terms papillary thyroid carcinoma with nodular fasciitis-like stroma and papillary thyroid carcinoma with fibromatosis-like stroma are used interchangeably; however, the former term suggests a self-limited and regressing disease, whereas the latter one suggests a recurrent and potentially aggressive one. Better genetic and ultrastructural characterization could lead to more appropriate terminology and management. We performed detailed clinicopathological and molecular analyses of two cases of PTC with prominent mesenchymal proliferation that developed in the thyroid gland of two male patients aged 34 and 48. In both cases, the epithelial component harbored a heterozygous somatic activating BRAF mutation (p.V600E). Also, in both cases, the mesenchymal component showed typical aberrant nuclear and cytoplasmic immunoreactivity for β-catenin and harbored a heterozygous somatic activating mutation in the corresponding CTNNB1 gene (p.S45P). This mutation has never been reported in thyroid stroma; in other tissues, it is typical of desmoid-type fibromatosis rather than nodular fasciitis-like stroma. We therefore propose that in cases of papillary thyroid carcinoma with a prominent mesenchymal component, mutations in CTNNB1 should be sought; when they are present, the term 'papillary thyroid carcinoma with desmoid-type fibromatosis' should be used. As the mesenchymal component of these tumors is not expected to concentrate radioactive iodine, special considerations apply to clinical evaluation and follow-up, which should be brought to the attention of the treating specialist.
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Rossi ED, Martini M, Bizzarro T, Schmitt F, Longatto-Filho A, Larocca LM. Somatic mutations in solid tumors: a spectrum at the service of diagnostic armamentarium or an indecipherable puzzle? The morphological eyes looking for BRAF and somatic molecular detections on cyto-histological samples. Oncotarget 2017; 8:3746-3760. [PMID: 27738305 PMCID: PMC5356915 DOI: 10.18632/oncotarget.12564] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 10/03/2016] [Indexed: 12/12/2022] Open
Abstract
This review article deals with the analysis and the detection of the morphological features associated with somatic mutations, mostly BRAFV600E mutation, on both cytological and histological samples of carcinomas. Few authors demonstrated that some architectural and specific cellular findings (i.e. polygonal eosinophilic cells defined as "plump cells" and sickle-shaped nuclei) are able to predict BRAF V600E mutation in both cytological and histological samples of papillary thyroid carcinoma (PTC) as well as in other carcinomas. In the current review article we evaluated the first comprehensive analysis of the morphological prediction of BRAFV600E and other somatic mutations in different malignant lesions with the description of the possible mechanisms beneath these morphologic features. The detection of predictive morphological features, mostly on FNAC, may add helpful information to the stratification of the malignant risk and personalized management of cancers. Additionally, the knowledge of the molecular mechanism of different oncogenic drivers can lead to the organ-specific triaging selection of cases and can provide significant insight for targeted therapies in different malignant lesions.
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Affiliation(s)
- Esther Diana Rossi
- Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, “Agostino Gemelli” School of Medicine, Rome, Italy
| | - Maurizio Martini
- Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, “Agostino Gemelli” School of Medicine, Rome, Italy
| | - Tommaso Bizzarro
- Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, “Agostino Gemelli” School of Medicine, Rome, Italy
| | - Fernando Schmitt
- Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Porto, Portugal
- Department of Medicine and Pathology, Laboratoire National de Santé, Luxembourg
| | - Adhemar Longatto-Filho
- Department of Pathology, Laboratory of Medical Investigation, University of São Paulo School of Medicine, Brazil
- Life and Health Sciences Research Institute, School of Health Sciences, University of Minho, Braga, Portugal
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal
- Molecular Oncology Research Center, Barretos Cancer Hospital, Pio XII Foundation, Barretos, Brazil
| | - Luigi Maria Larocca
- Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, “Agostino Gemelli” School of Medicine, Rome, Italy
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Martinuzzi C, Pastorino L, Andreotti V, Garuti A, Minuto M, Fiocca R, Bianchi-Scarrà G, Ghiorzo P, Grillo F, Mastracci L. A combination of immunohistochemistry and molecular approaches improves highly sensitive detection of BRAF mutations in papillary thyroid cancer. Endocrine 2016; 53:672-80. [PMID: 26296380 DOI: 10.1007/s12020-015-0720-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/08/2015] [Indexed: 12/19/2022]
Abstract
The optimal method for BRAF mutation detection remains to be determined despite advances in molecular detection techniques. The aim of this study was to compare, against classical Sanger sequencing, the diagnostic performance of two of the most recently developed, highly sensitive methods: BRAF V600E immunohistochemistry (IHC) and peptide nucleic-acid (PNA)-clamp qPCR. BRAF exon 15 mutations were searched in formalin-fixed paraffin-embedded tissues from 86 papillary thyroid carcinoma using the three methods. The limits of detection of Sanger sequencing in borderline or discordant cases were quantified by next generation sequencing. BRAF mutations were found in 74.4 % of cases by PNA, in 71 % of cases by IHC, and in 64 % of cases by Sanger sequencing. Complete concordance for the three methods was observed in 80 % of samples. Better concordance was observed with the combination of two methods, particularly PNA and IHC (59/64) (92 %), while the combination of PNA and Sanger was concordant in 55 cases (86 %). Sensitivity of the three methods was 99 % for PNA, 94.2 % for IHC, and 89.5 % for Sanger. Our data show that IHC could be used as a cost-effective, first-line method for BRAF V600E detection in daily practice, followed by PNA analysis in negative or uninterpretable cases, as the most efficient method. PNA-clamp quantitative PCR is highly sensitive and complementary to IHC as it also recognizes other mutations besides V600E and it is suitable for diagnostic purposes.
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Affiliation(s)
- Claudia Martinuzzi
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
- Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
| | - Lorenza Pastorino
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
| | - Virginia Andreotti
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
| | - Anna Garuti
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
| | - Michele Minuto
- Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
- Surgery 1 Unit, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Roberto Fiocca
- Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
- Pathology Unit, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Giovanna Bianchi-Scarrà
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy
- Genetics of Rare Tumors, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy
| | - Paola Ghiorzo
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, V.le Benedetto XV 6, 16132, Genoa, Italy.
- Genetics of Rare Tumors, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy.
| | - Federica Grillo
- Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
- Pathology Unit, IRCCS AOU San Martino-IST, Genoa, Italy
| | - Luca Mastracci
- Department of Surgical Sciences (DISC), University of Genoa, Genoa, Italy
- Pathology Unit, IRCCS AOU San Martino-IST, Genoa, Italy
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Yeo MK, Jung MK, Lee SY, Lee YM, Hur GM, Kim JM. The usefulness of a novel fully automated PCR-based Idylla test for detection of the BRAF V600E mutation in thyroid tissue: comparison with PNA-clamping PCR, real-time PCR and pyrosequencing. J Clin Pathol 2016; 70:260-265. [PMID: 27543599 DOI: 10.1136/jclinpath-2016-204025] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 07/27/2016] [Accepted: 07/28/2016] [Indexed: 12/16/2022]
Abstract
INTRODUCTION The BRAF V600E mutation is the most common genetic event in papillary thyroid carcinoma (PTC). The BRAF V600E mutational status has a significant diagnostic and prognostic role in PTC since it can be detected in 32%-87% of PTC by various molecular methods. AIMS A novel, fully automated real-time PCR-based Idylla test is assessed to detect the BRAF mutation in formalin-fixed paraffin-embedded (FFPE) thyroid samples. METHODS 99 PTC and 11 nodular hyperplasia FFPE thyroid tissues are evaluated for the BRAF V600E mutation by the Idylla tests and compared with peptide nucleic acid-clamping PCR, real-time PCR and pyrosequencing. RESULTS The sensitivity and specificity of the Idylla test to detect BRAF V600E are 98.8% and 100%, which is superior to real-time PCR and pyrosequencing. The concordance between Idylla and true positive is highest at 0.974. CONCLUSIONS This study validates that the Idylla test is a sensitive and specific method to detect BRAF V600E in FFPE thyroid tissues. A simple, quick and easy to handle Idylla test is a useful and reliable molecular technique to evaluate BRAF mutations.
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Affiliation(s)
- Min-Kyung Yeo
- Department of Pathology and Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
| | - Min-Kyu Jung
- Department of Pathology and Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
| | - Su-Yel Lee
- Biobank of Chungnam National University Hospital, Daejeon, Korea
| | - Yong-Moon Lee
- Department of Pathology and Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
| | - Gang Min Hur
- Department of Pharmacology, Chungnam National University School of Medicine, Daejeon, Korea
| | - Jin-Man Kim
- Department of Pathology and Medical Science, Chungnam National University School of Medicine, Daejeon, Korea
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Gandolfi G, Dallaglio K, Longo C, Moscarella E, Lallas A, Alfano R, Argenziano G, Ciarrocchi A. Contemporary and potential future molecular diagnosis of melanoma. Expert Rev Mol Diagn 2016; 16:975-85. [DOI: 10.1080/14737159.2016.1206473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- G. Gandolfi
- Laboratory of Translational Research, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - K. Dallaglio
- Laboratory of Translational Research, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - C. Longo
- Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - E. Moscarella
- Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - A. Lallas
- Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - R. Alfano
- Surgery and Emergency Unit, Second University of Naples, Naples, Italy
| | - G. Argenziano
- Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy
- Dermatology Unit, Second University of Naples, Naples, Italy
| | - A. Ciarrocchi
- Laboratory of Translational Research, Arcispedale S. Maria Nuova-IRCCS, Reggio Emilia, Italy
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Gugnoni M, Sancisi V, Gandolfi G, Manzotti G, Ragazzi M, Giordano D, Tamagnini I, Tigano M, Frasoldati A, Piana S, Ciarrocchi A. Cadherin-6 promotes EMT and cancer metastasis by restraining autophagy. Oncogene 2016; 36:667-677. [PMID: 27375021 DOI: 10.1038/onc.2016.237] [Citation(s) in RCA: 146] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 05/25/2016] [Accepted: 06/03/2016] [Indexed: 02/07/2023]
Abstract
The transdifferentiation of epithelial cells toward a mesenchymal condition (EMT) is a complex process that allows tumor cells to migrate to ectopic sites. Cadherins are not just structural proteins, but they act as sensors of the surrounding microenvironment and as signaling centers for cellular pathways. However, the molecular mechanisms underlying these signaling functions remain poorly characterized. Cadherin-6 (CDH6) is a type 2 cadherin, which drives EMT during embryonic development and it is aberrantly re-activated in cancer. We recently showed that CDH6 is a TGFβ target and an EMT marker in thyroid cancer, suggesting a role for this protein in the progression of this type of tumor. Papillary thyroid carcinomas (PTCs) are usually indolent lesions. However, metastatic spreading occurs in about 5% of the cases. The identification of molecular markers that could early predict the metastatic potential of these lesions would be strategic to design more tailored approaches and reduce patients overtreatment. In this work, we assessed the role of CDH6 in the metastatic progression of thyroid cancer. We showed that loss of CDH6 expression profoundly changes cellular architecture, alters the inter-cellular interaction modalities and attenuates EMT features in thyroid cancer cells. Using a yeast two-hybrid screening approach, based on a thyroid cancer patients library, we showed that CDH6 directly interacts with GABARAP, BNIP3 and BNIP3L, and that through these interactions CDH6 restrains autophagy and promotes re-organization of mitochondrial network through a DRP1-mediated mechanism. Analysis of the LIR domains suggests that the interaction with the autophagic machinery may be a common feature of many cadherin family members. Finally, the analysis of CDH6 expression in a unique cohort of human PTCs showed that CDH6 expression marks specifically EMT cells. and it is strongly associated with metastatic behavior and worse outcome of PTCs.
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Affiliation(s)
- M Gugnoni
- Laboratory of Translational Research, Department of Scientific Direction, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - V Sancisi
- Laboratory of Translational Research, Department of Scientific Direction, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - G Gandolfi
- Laboratory of Translational Research, Department of Scientific Direction, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - G Manzotti
- Laboratory of Translational Research, Department of Scientific Direction, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - M Ragazzi
- Pathology Unit, Deptartment of Oncology and Advanced Technologies, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - D Giordano
- Otolaryngology Unit, Department of General Surgery and Specialistic Unit, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - I Tamagnini
- Pathology Unit, Deptartment of Oncology and Advanced Technologies, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - M Tigano
- Laboratory of Translational Research, Department of Scientific Direction, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - A Frasoldati
- Endocrinology Unit, Department of General Surgery and Specialistic Unit, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - S Piana
- Pathology Unit, Deptartment of Oncology and Advanced Technologies, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy
| | - A Ciarrocchi
- Laboratory of Translational Research, Department of Scientific Direction, Arcispedale S Maria Nuova-IRCCS, Reggio Emilia, Italy
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Rossi ED, Schmitt F. When Morphology Meets Somatic Mutations: The New Possible Scenario in Thyroid Fine-Needle Aspiration. Acta Cytol 2016; 60:93-6. [PMID: 27288325 DOI: 10.1159/000446796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 05/04/2016] [Indexed: 12/30/2022]
Abstract
This study points to the analysis of the morphological features suggestive of somatic mutations, mostly the BRAFV600E mutation, on cytological samples of thyroid carcinomas. According to the literature, the application of ancillary techniques on cytology comes in handy as a challenging aid in ruling out a malignant outcome on both conventional and liquid-based cytological preparations. However, the evaluation of somatic mutations, including BRAFV600E, usually performed by DNA techniques, may have some limitations in a worldwide diffusion. In this perspective, few authors emphasized the morphological search for BRAFV600E mutations harbored in papillary thyroid carcinoma (PTC) and characterized by specific architectural and cellular findings (i.e. eosinophilic cells defined as 'plump cells' and sickle-shaped nuclei). Hence, the detection of eosinophilic cytoplasm of mutated PTC cells seems to suggest the possible involvement of the 'Warburg effect' pioneering the ability of cancer cells to convert glucose into lactic acid. The recent yields of immunohistochemical expression of monocarboxylate transporters in mutated PTCs may suggest the accumulation of lactate in these plump cells. Equally importantly, the detection of these morphological findings using fine-needle aspiration cytology may be helpful in triaging thyroid lesions and limiting costs. Additionally, it may lead to the stratification of the malignant risk and personalized management in cases with multifocal lesions.
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Affiliation(s)
- Esther Diana Rossi
- Division of Anatomic Pathology and Histology, Agostino Gemelli School of Medicine, Universitx00E0; Cattolica del Sacro Cuore, Rome, Italy
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Rossi ED, Bizzarro T, Martini M, Capodimonti S, Cenci T, Fadda G, Schmitt F, Larocca LM. Morphological features that can predict BRAF V600E -mutated carcinoma in paediatric thyroid cytology. Cytopathology 2016; 28:55-64. [PMID: 27256275 DOI: 10.1111/cyt.12350] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2016] [Indexed: 12/22/2022]
Abstract
OBJECTIVE BRAFV600E represents the most common diagnostic marker in papillary thyroid carcinoma (PTC). A few papers have demonstrated the correlation between BRAFV600E and specific morphological findings on PTCs in the adult population. This is the first reported series investigating cytological morphological parameters in paediatric thyroid carcinoma. METHODS One hundred and nineteen paediatric samples (56 male and 63 female patients), diagnosed in the period between April 2013 and July 2015, were enrolled in the study. Fifteen patients with inadequate results were excluded. Cytological cases were processed with liquid-based cytology (LBC). BRAFV600E and immunocytochemistry for the VE1 antibody were performed on LBC. RESULTS The diagnostic series included 10 mutated and 94 wild-type (WT) cases. Twenty two percent surgical samples showed 96% cytohistological concordance. The morphological analysis revealed plump cells (abundant eosinophilic cytoplasm and PTC nuclei) in all 10 mutated cases with only four cases showing a focal (less than 20% of the cells) plump component. None of the WT showed plump cells. A sickle nuclear shape was seen only in the mutated cases. VE1 yielded 100% positivity on mutated cases with three cytohistological discrepancies. CONCLUSIONS The BRAFV600E mutation is also seen in paediatric cytology and the morphological features showed a high accuracy as both predictive mutational parameters and a helpful aid in management mainly of the aggressive BRAFV600E mutated carcinomas.
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Affiliation(s)
- E D Rossi
- Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, "Agostino Gemelli" School of Medicine, Rome, Italy
| | - T Bizzarro
- Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, "Agostino Gemelli" School of Medicine, Rome, Italy
| | - M Martini
- Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, "Agostino Gemelli" School of Medicine, Rome, Italy
| | - S Capodimonti
- Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, "Agostino Gemelli" School of Medicine, Rome, Italy
| | - T Cenci
- Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, "Agostino Gemelli" School of Medicine, Rome, Italy
| | - G Fadda
- Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, "Agostino Gemelli" School of Medicine, Rome, Italy
| | - F Schmitt
- Instituto de Patologia e Imunologia Molecular da Universidade do Porto (IPATIMUP), Porto, Portugal.,Laboratorie National de Sante, Dudelange, Luxembourg
| | - L M Larocca
- Division of Anatomic Pathology and Histology, Università Cattolica del Sacro Cuore, "Agostino Gemelli" School of Medicine, Rome, Italy
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36
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Kowalska A, Walczyk A, Kowalik A, Pałyga I, Trybek T, Kopczyński J, Kajor M, Chrapek M, Pięciak L, Chłopek M, Góźdź S, Kamiński G. Increase in Papillary Thyroid Cancer Incidence Is Accompanied by Changes in the Frequency of the BRAF V600E Mutation: A Single-Institution Study. Thyroid 2016; 26:543-51. [PMID: 26889698 DOI: 10.1089/thy.2015.0352] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Thyroid cancer (TC) has one of the fastest increasing incidences worldwide and primarily involves papillary thyroid cancer (PTC). The BRAF(V600E) mutation is the most common genetic alteration identified in PTC. There are few data concerning an association between the rising incidence of PTC and the increasing prevalence of BRAF-positive cases. Environmental factors such as iodine intake may be responsible for the changing molecular features of PTC. The aim of this study was to evaluate probable variations in the frequency of the BRAF(V600E) mutation in PTC that were diagnosed at a single institution over 14 years in Poland, a country with a demonstrated improvement in iodine supplementation in the early 21st century. METHODS Time-dependent trends in the prevalence of the BRAF(V600E) mutation during three time periods (2000-2004, 2005-2009, and 2010-2013) were analyzed. The BRAF mutation was genotyped using direct sequencing, allele-specific polymerase chain reaction (PCR), and real-time PCR in 723 unselected cases of PTC that were diagnosed in 2000-2013. Trends in the clinicopathologic characteristics of all PTCs and BRAF(V600E)-positive PTCs were also analyzed. RESULTS The proportion of PTCs with mutations significantly increased over the study period (54.8% vs. 70.6%; p = 0.001). The median tumor size of all and BRAF-positive tumors decreased (p = 0.008 and p = 0.001, respectively) and correlated with an increase in the proportion of all and mutated microcarcinomas (p = 0.003 and p = 0.003, respectively). A decrease in all and mutated tumors between 2 and 4 cm was also observed (p = 0.002 and p = 0.006, respectively). A significant decrease in tumors ≥ 4 cm in size was only observed in BRAF-positive cases (p = 0.017). The proportion of classic PTC with BRAF(V600E) mutation was observed to increase (57.6% vs. 74.4%; p = 0.001) and was stable for the follicular variant of PTC (p = 0.336). CONCLUSIONS The prevalence of the BRAF(V600E)mutation increased significantly in PTCs diagnosed in the authors' institution. Improved detection and several causative factors, most likely environmental and changes in iodine intake, may contribute to the increasing occurrence of TC.
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Affiliation(s)
- Aldona Kowalska
- 1 Department of Endocrinology, Holycross Cancer Centre , Kielce, Poland
| | - Agnieszka Walczyk
- 1 Department of Endocrinology, Holycross Cancer Centre , Kielce, Poland
| | - Artur Kowalik
- 2 Department of Molecular Diagnostics, Holycross Cancer Centre , Kielce, Poland
| | - Iwona Pałyga
- 1 Department of Endocrinology, Holycross Cancer Centre , Kielce, Poland
| | - Tomasz Trybek
- 1 Department of Endocrinology, Holycross Cancer Centre , Kielce, Poland
| | - Janusz Kopczyński
- 3 Department of Surgical Pathology, Holycross Cancer Centre , Kielce, Poland
| | - Maciej Kajor
- 4 Department of Surgical Pathology, Medical University of Silesia , Katowice, Poland
| | - Magdalena Chrapek
- 5 Department of Probability Theory and Statistics Institute of Mathematics, Faculty of Mathematics and Natural Science, Jan Kochanowski University , Kielce, Poland
| | - Liliana Pięciak
- 2 Department of Molecular Diagnostics, Holycross Cancer Centre , Kielce, Poland
| | - Małgorzata Chłopek
- 2 Department of Molecular Diagnostics, Holycross Cancer Centre , Kielce, Poland
| | - Stanisław Góźdź
- 6 Department of Clinical Oncology, Holycross Cancer Centre , Kielce, Poland
- 7 Faculty of Health Sciences, Jan Kochanowski University , Kielce, Poland
| | - Grzegorz Kamiński
- 8 Department of Endocrinology and Nuclear Medicine, Military Institute of Medicine , Warsaw, Poland
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Bongiovanni M, Trimboli P, Rossi ED, Fadda G, Nobile A, Giovanella L. DIAGNOSIS OF ENDOCRINE DISEASE: High-yield thyroid fine-needle aspiration cytology: an update focused on ancillary techniques improving its accuracy. Eur J Endocrinol 2016; 174:R53-63. [PMID: 26450171 DOI: 10.1530/eje-15-0817] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 10/07/2015] [Indexed: 01/21/2023]
Abstract
Thyroid fine-needle aspiration (FNA) cytology is a fast growing field. One of the most developing areas is represented by molecular tests applied to cytological material. Patients that could benefit the most from these tests are those that have been diagnosed as 'indeterminate' on FNA. They could be better stratified in terms of malignancy risk and thus oriented with more confidence to the appropriate management. Taking in to consideration the need to improve and keep high the yield of thyroid FNA, professionals from various fields (i.e. molecular biologists, endocrinologists, nuclear medicine physicians and radiologists) are refining and fine-tuning their diagnostic instruments. In particular, all these developments aim at increasing the negative predictive value of FNA to improve the selection of patients for diagnostic surgery. These advances involve terminology, the application of next-generation sequencing to thyroid FNA, the use of immunocyto- and histo-chemistry, the development of new sampling techniques and the increasing use of nuclear medicine as well as molecular imaging in the management of patients with a thyroid nodule. Herein, we review the recent advances in thyroid FNA cytology that could be of interest to the 'thyroid-care' community, with particular focus on the indeterminate diagnostic category.
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Affiliation(s)
| | - P Trimboli
- Institute of PathologyUniversity Hospital, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandSection of Endocrinology and DiabetologyOspedale Israelitico, Piazza San Bartolomeo all'Isola 21, 00186 Rome, ItalyDepartment of Nuclear Medicine and Thyroid CentreOncology Institute of Southern Switzerland, Viale Officina 3, 6500 Bellinzona, SwitzerlandDivision of Anatomic Pathology and HistologyDepartment of Laboratory Medicine, 'Agostino Gemelli' School of Medicine and Hospital, Catholic University, Largo Francesco Vito 1, 00168 Rome, Italy Institute of PathologyUniversity Hospital, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandSection of Endocrinology and DiabetologyOspedale Israelitico, Piazza San Bartolomeo all'Isola 21, 00186 Rome, ItalyDepartment of Nuclear Medicine and Thyroid CentreOncology Institute of Southern Switzerland, Viale Officina 3, 6500 Bellinzona, SwitzerlandDivision of Anatomic Pathology and HistologyDepartment of Laboratory Medicine, 'Agostino Gemelli' School of Medicine and Hospital, Catholic University, Largo Francesco Vito 1, 00168 Rome, Italy
| | - E D Rossi
- Institute of PathologyUniversity Hospital, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandSection of Endocrinology and DiabetologyOspedale Israelitico, Piazza San Bartolomeo all'Isola 21, 00186 Rome, ItalyDepartment of Nuclear Medicine and Thyroid CentreOncology Institute of Southern Switzerland, Viale Officina 3, 6500 Bellinzona, SwitzerlandDivision of Anatomic Pathology and HistologyDepartment of Laboratory Medicine, 'Agostino Gemelli' School of Medicine and Hospital, Catholic University, Largo Francesco Vito 1, 00168 Rome, Italy
| | - G Fadda
- Institute of PathologyUniversity Hospital, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandSection of Endocrinology and DiabetologyOspedale Israelitico, Piazza San Bartolomeo all'Isola 21, 00186 Rome, ItalyDepartment of Nuclear Medicine and Thyroid CentreOncology Institute of Southern Switzerland, Viale Officina 3, 6500 Bellinzona, SwitzerlandDivision of Anatomic Pathology and HistologyDepartment of Laboratory Medicine, 'Agostino Gemelli' School of Medicine and Hospital, Catholic University, Largo Francesco Vito 1, 00168 Rome, Italy
| | | | - L Giovanella
- Institute of PathologyUniversity Hospital, Rue du Bugnon 25, 1011 Lausanne, SwitzerlandSection of Endocrinology and DiabetologyOspedale Israelitico, Piazza San Bartolomeo all'Isola 21, 00186 Rome, ItalyDepartment of Nuclear Medicine and Thyroid CentreOncology Institute of Southern Switzerland, Viale Officina 3, 6500 Bellinzona, SwitzerlandDivision of Anatomic Pathology and HistologyDepartment of Laboratory Medicine, 'Agostino Gemelli' School of Medicine and Hospital, Catholic University, Largo Francesco Vito 1, 00168 Rome, Italy
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Daignault CP, Palmer EL, Scott JA, Swan JS, Daniels GH. Papillary Thyroid Carcinoma Metastasis to the Lumbar Spine Masquerading as a Schmorl's Node. Nucl Med Mol Imaging 2015; 49:217-22. [PMID: 26279695 DOI: 10.1007/s13139-015-0320-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 01/15/2015] [Accepted: 01/18/2015] [Indexed: 11/26/2022] Open
Abstract
A Schmorl's node is a common incidental finding encountered during radiologic imaging. Despite the vertebral body being a common site of metastatic disease, a lytic lesion adjacent to an endplate with typical imaging features can often confidently be called a Schmorl's node. This is a case report of a patient with a single well-defined FDG-avid papillary thyroid carcinoma metastasis to the spine that had imaging findings characteristic of a Schmorl's node on CT and MRI. This case is important to consider as it demonstrates that the imaging characteristics of metastatic disease and Schmorl's nodes can overlap.
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Affiliation(s)
- Cory P Daignault
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114 USA ; Department of Radiology, Division of Nuclear Medicine, UMass Memorial Medical Center, 55 Lake Ave N, Worcester, MA 01655 USA
| | - Edwin L Palmer
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114 USA
| | - James A Scott
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114 USA
| | - John S Swan
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114 USA
| | - Gilbert H Daniels
- Thyroid Unit and Department of Medicine, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114 USA
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BRAF inhibitors: experience in thyroid cancer and general review of toxicity. Discov Oncol 2014; 6:21-36. [PMID: 25467940 DOI: 10.1007/s12672-014-0207-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 11/11/2014] [Indexed: 12/20/2022] Open
Abstract
The US Food and Drug Administration-approved BRAF inhibitors, vemurafenib and dabrafenib, have demonstrated superior efficacy in patients with BRAF-mutant melanomas but have limited efficacy in BRAF-mutant colorectal cancer. Little is known at this time regarding BRAF inhibitors in thyroid cancer. Initial reports in patients with progressive, radioactive iodine-refractory BRAF-mutant papillary thyroid cancer suggest response rates of approximately 30-40%. In this review, we discuss BRAF inhibitors in the context of thyroid cancer, the toxicities associated with BRAF inhibitors, and the suggested management of those toxicities. The management of vemurafenib and dabrafenib toxicities is applicable across all tumor types and may serve as a practical guide to their use.
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40
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Ragazzi M, Ciarrocchi A, Sancisi V, Gandolfi G, Bisagni A, Piana S. Update on anaplastic thyroid carcinoma: morphological, molecular, and genetic features of the most aggressive thyroid cancer. Int J Endocrinol 2014; 2014:790834. [PMID: 25214840 PMCID: PMC4158294 DOI: 10.1155/2014/790834] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 07/08/2014] [Indexed: 12/19/2022] Open
Abstract
Anaplastic thyroid carcinoma (ATC) is the most aggressive form of thyroid cancer. It shows a wide spectrum of morphological presentations and the diagnosis could be challenging due to its high degree of dedifferentiation. Molecular and genetic features of ATC are widely heterogeneous as well and many efforts have been made to find a common profile in order to clarify its cancerogenetic process. A comprehensive review of the current literature is here performed, focusing on histopathological and genetic features.
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Affiliation(s)
- Moira Ragazzi
- Pathology Unit, IRCCS-Arcispedale Santa Maria Nuova, Viale Risorgimento 80, 42123 Reggio Emilia, Italy
| | - Alessia Ciarrocchi
- Laboratory of Translational Research, Research and Statistic Infrastructure, Arcispedale S. Maria Nuova-IRCCS, 42123 Reggio Emilia, Italy
| | - Valentina Sancisi
- Laboratory of Translational Research, Research and Statistic Infrastructure, Arcispedale S. Maria Nuova-IRCCS, 42123 Reggio Emilia, Italy
| | - Greta Gandolfi
- Laboratory of Translational Research, Research and Statistic Infrastructure, Arcispedale S. Maria Nuova-IRCCS, 42123 Reggio Emilia, Italy
| | - Alessandra Bisagni
- Pathology Unit, IRCCS-Arcispedale Santa Maria Nuova, Viale Risorgimento 80, 42123 Reggio Emilia, Italy
| | - Simonetta Piana
- Pathology Unit, IRCCS-Arcispedale Santa Maria Nuova, Viale Risorgimento 80, 42123 Reggio Emilia, Italy
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