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Morand GB, Tessler I, Krasner J, Pusztaszeri MP, Yamin T, Gecel NA, Avior G, Payne RJ. Investigation of genetic sex-specific molecular profile in well-differentiated thyroid cancer: Is there a difference between females and males? Clin Otolaryngol 2023; 48:748-755. [PMID: 37212457 DOI: 10.1111/coa.14075] [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: 11/22/2022] [Revised: 03/28/2023] [Accepted: 05/01/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Although more common in females, thyroid cancer is deemed to be more aggressive in males. The reasons for sex disparities in thyroid cancer are not well understood. We hypothesised that differences in molecular mutations between females and males contribute to this phenomenon. METHODS Retrospective multicentre multinational study of thyroid nodules that underwent preoperative molecular profiling between 2015 and 2022. The clinical characteristics and mutational profiles of tumours in female and male patients were compared. Collected data included demographics, cytology results, surgical pathology, and molecular alterations. RESULTS A total of 738 patients were included of which 571 (77.4%) were females. The extrathyroidal extension was more common in malignancies in males (chi-squared, p = 0.028). The rate of point mutations and gene fusions were similar in both sex groups (p > 0.05 for all mutations). Patients with nodules with BRAFV600E mutations were significantly younger than BRAF wild-type nodule patients (t-test, p = 0.0001). Conversely, patients with TERT promoter mutations were significantly older than patients with wild-type TERT (t-test, p < 0.0001). For patients harbouring both BRAFV600E and TERT mutations, the difference in age at presentation was significantly different in females (t-test, p = 0.009) but not in males (t-test, p = 0.433). Among females, patients with BRAFV600E and TERT mutations were significantly older than their wild-type or single-mutation counterpart (t-test, p = 0.003). CONCLUSION The absolute rate of molecular mutations was similar in females and males. We found that extrathyroidal extension was more common in males. Moreover, BRAFV600E and TERT mutations occur at a younger age in males than in females. These two findings are factors that may explain the tendency of more aggressive disease in males.
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Affiliation(s)
- Grégoire B Morand
- Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
- Department of Otorhinolaryngology-Head and Neck Surgery, Luzerner Kantonsspital, Lucerne, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Idit Tessler
- Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel
| | - Josh Krasner
- Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Marc P Pusztaszeri
- Department of Pathology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Tzahi Yamin
- Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel
| | - Nir A Gecel
- Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Tel-Aviv University, Tel-Aviv, Israel
| | - Galit Avior
- Department of Otolaryngology-Head and Neck Surgery, Sheba Medical Center, Technion University, Tel-Aviv, Israel
| | - Richard J Payne
- Department of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
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Construction of prediction models for determining the risk of lateral lymph node metastasis in patients with thyroid papillary carcinoma based on gender stratification. Eur Arch Otorhinolaryngol 2023; 280:2511-2523. [PMID: 36622416 DOI: 10.1007/s00405-022-07812-x] [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: 10/29/2022] [Accepted: 12/20/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Lateral lymph node metastasis (LLNM) is associated with poor prognosis in patients with papillary thyroid cancer (PTC). The purpose of this study was to determine the risk factors for LLNM and establish prediction models that could individually assessed the risk of LLNM. METHODS A total of 619 PTC patients were retrospectively analyzed in our study. Univariate and multivariate analysis were performed for male and female patients, respectively, to assess relationships between clinicopathological features and LLNM. By integrating independent predictors selected by binary logistic regression modeling, preoperative and postoperative nomograms were developed to estimate the risk of LLNM. RESULTS LLNM was detected in 80 of 216 male patients. Of 403 female patients, 114 had LLNM. The preoperative nomogram of male patients included three clinical variables: the number of foci, tuner size, and echogenic foci. In addition to the above three variables, the postoperative nomogram of male patients included extrathyroidal extension (ETE) detected in surgery, central lymph node metastasis (CLNM) and high-volume CLNM. The preoperative nomogram of female patients included the following variables: age, chronic lymphocytic thyroiditis (CLT), BRAF V600E, the number of foci, tumor size and echogenic foci. Variables such as CLT, BRAF V600E, the number of foci, tumor size, ETE detected in surgery, CLNM, high-volume CLNM and central lymph node ratio were included in the postoperative nomogram. Above Nomograms show good discrimination. CONCLUSIONS Considering the difference in the incidence rate of LLNM between men and women, a separate prediction system should be established for patients of different genders. These nomograms are helpful in promoting the risk stratification of PTC treatment decision-making and postoperative management.
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A Systematic Review and Meta-analysis on the Occurrence of Biomarker Mutation in Colorectal Cancer among the Asian Population. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5824183. [PMID: 35782059 PMCID: PMC9246611 DOI: 10.1155/2022/5824183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 05/24/2022] [Indexed: 12/24/2022]
Abstract
Globally, colorectal carcinoma (CRC) is the third most common cancer and the third major cause of cancer-related death in both sexes. KRAS and BRAF mutations are almost mutually exclusively involved in the pathogenesis of CRC. Both are major culprits in treatment failure and poor prognosis for CRC. Method. A systematic review and meta-analysis of various research was done following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. This trial is registered with PROSPERO CRD42021256452. The initial search included 646 articles; after the removal of noneligible studies, a total of 88 studies was finally selected. Data analysis was carried out using OpenMeta Analyst and Comprehensive Meta-Analysis 3.0 (CMA 3.0) software to investigate the prevalence of KRAS and BRAF mutations among patients with CRC in Asia. Results. The meta-analysis comprises of 25,525 sample sizes from Asia with most being male 15,743/25525 (61.7%). Overall prevalence of KRAS mutations was (59/88) 36.3% (95% CI: 34.5-38.2) with I2 = 85.54% (P value < 0.001). In 43/59 studies, frequency of KRAS mutations was majorly in codon 12 (76.6% (95% CI: 74.2–78.0)) and less in codon 13 (21.0% (95% CI: 19.1-23.0)). Overall prevalence of BRAF mutations was 5.6% (95% CI: 3.9-8.0) with I2 = 94.00% (P value < 0.001). When stratified according to location, a higher prevalence was observed in Indonesia (71.8%) while Pakistan has the lowest (13.5%). Conclusion. Total prevalence of KRAS and BRAF mutations in CRC was 36.6% and 5.6%, respectively, and the results conformed with several published studies on KRAS and BRAF mutations.
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Zurnadzhy L, Bogdanova T, Rogounovitch TI, Ito M, Tronko M, Yamashita S, Mitsutake N, Bolgov M, Chernyshov S, Masiuk S, Saenko VA. Clinicopathological Implications of the BRAF V600E Mutation in Papillary Thyroid Carcinoma of Ukrainian Patients Exposed to the Chernobyl Radiation in Childhood: A Study for 30 Years After the Accident. Front Med (Lausanne) 2022; 9:882727. [PMID: 35665338 PMCID: PMC9159157 DOI: 10.3389/fmed.2022.882727] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 03/18/2022] [Indexed: 01/09/2023] Open
Abstract
With time after the Chernobyl accident, the number of papillary thyroid carcinomas (PTCs) driven by the BRAFV600E oncoprotein is growing in patients exposed to radiation at a young age. Clinicopathological associations of BRAFV600E in PTCs from patients with internal radiation history have not been sufficiently studied so far. This work analyzes the structural characteristics, proliferative activity, invasive features, clinical information, and dosimetric data in the BRAFV600E-positive and BRAFV600E-negative PTCs from the Ukrainian patients exposed to Chernobyl radiation and treated over 30 years after the accident. The study included 428 PTCs from patients aged 4-49 years at surgery who lived in the six northern regions of Ukraine most contaminated by 131I, were ≤18 years of age at the time of exposure, and were operated on from 1990 to 2017. Immunohistochemical staining for BRAFV600E was performed with the VE1 antibody. The probability of causation (POC) of a tumor due to radiation was determined using an interactive online NIH/NCI software. BRAFV600E was detected in 136/428 (31.8%) PTCs. In comparison with the BRAFV600E-negative PTCs, the BRAFV600E-positivity was associated with older patient age at the accident and at surgery, a longer period of latency, and lower POC. The BRAFV600E-positive PTCs were characterized by smaller tumor size, higher Ki67 labeling index, more frequent oncocytic changes, multifocality, and dominant papillary growth pattern. Tumor invasive features were less frequent in the BRAFV600E-positive PTCs and did not change with POC level. Despite a less aggressive tumor phenotype, BRAFV600E was a risk factor for recurrence, namely radioiodine-refractory (RAI-R) recurrent metastases. Multivariate models of RAI-R included BRAFV600E and/or histopathological parameters closely correlating with BRAFV600E such as tumor size, multifocality, dominant papillary growth pattern, or oncocytic changes. Thus, the BRAFV600E-positive PTCs from patients from a high-risk group for radiogenic thyroid cancer diagnosed in the 30 years after the Chernobyl accident did not display higher invasiveness regardless of POC level, but in view of the prognostic impact of this genetic alteration, knowledge of the BRAF status may be beneficial for middle-aged patients with radiogenic PTC considered for RAI therapy, and suggests more careful follow-up of patients with the BRAFV600E-positive tumors.
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Affiliation(s)
- Liudmyla Zurnadzhy
- Laboratory of Morphology of Endocrine System, State Institution "VP Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine", Kyiv, Ukraine.,Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Tetiana Bogdanova
- Laboratory of Morphology of Endocrine System, State Institution "VP Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine", Kyiv, Ukraine.,Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Tatiana I Rogounovitch
- Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Masahiro Ito
- Department of Diagnostic Pathology, National Hospital Organization Nagasaki Medical Center, Omura, Japan
| | - Mykola Tronko
- Department of Fundamental and Applied Problems of Endocrinology, State Institution "VP Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine", Kyiv, Ukraine
| | - Shunichi Yamashita
- Fukushima Medical University, Fukushima, Japan.,National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Norisato Mitsutake
- Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.,Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Michael Bolgov
- Department of Surgery of Endocrine Glands, State Institution "VP Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine", Kyiv, Ukraine
| | - Serhii Chernyshov
- Department of Surgery of Endocrine Glands, State Institution "VP Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine", Kyiv, Ukraine
| | - Sergii Masiuk
- Radiation Protection Laboratory, State Institution "National Research Center of Radiation Medicine of the National Academy of Medical Science of Ukraine", Kyiv, Ukraine
| | - Vladimir A Saenko
- Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
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Chang Q, Zhang J, Wang Y, Li H, Du X, Zuo D, Yin D. Nomogram model based on preoperative serum thyroglobulin and clinical characteristics of papillary thyroid carcinoma to predict cervical lymph node metastasis. Front Endocrinol (Lausanne) 2022; 13:937049. [PMID: 35909521 PMCID: PMC9337858 DOI: 10.3389/fendo.2022.937049] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Preoperative evaluation of cervical lymph node metastasis (LNM) in papillary thyroid carcinoma (PTC) has been one of the serious clinical challenges. The present study aims at understanding the relationship between preoperative serum thyroglobulin (PS-Tg) and LNM and intends to establish nomogram models to predict cervical LNM. METHODS The data of 1,324 PTC patients were retrospectively collected and randomly divided into training cohort (n = 993) and validation cohort (n = 331). Univariate and multivariate logistic regression analyses were performed to determine the risk factors of central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM). The nomogram models were constructed and further evaluated by 1,000 resampling bootstrap analyses. The receiver operating characteristic curve (ROC curve), calibration curve, and decision curve analysis (DCA) of the nomogram models were carried out for the training, validation, and external validation cohorts. RESULTS Analyses revealed that age, male, maximum tumor size >1 cm, PS-Tg ≥31.650 ng/ml, extrathyroidal extension (ETE), and multifocality were the significant risk factors for CLNM in PTC patients. Similarly, such factors as maximum tumor size >1 cm, PS-Tg ≥30.175 ng/ml, CLNM positive, ETE, and multifocality were significantly related to LLNM. Two nomogram models predicting the risk of CLNM and LLNM were established with a favorable C-index of 0.801 and 0.911, respectively. Both nomogram models demonstrated good calibration and clinical benefits in the training and validation cohorts. CONCLUSION PS-Tg level is an independent risk factor for both CLNM and LLNM. The nomogram based on PS-Tg and other clinical characteristics are effective for predicting cervical LNM in PTC patients.
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Affiliation(s)
- Qungang Chang
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Medicine Laboratory of Thyroid Cancer of Henan Province, Zhengzhou, China
| | - Jieming Zhang
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yaqian Wang
- Department of Surgery, The First Affiliated Hospital of ZhengZhou University, Zhengzhou, China
| | - Hongqiang Li
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Medicine Laboratory of Thyroid Cancer of Henan Province, Zhengzhou, China
| | - Xin Du
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Daohong Zuo
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Detao Yin
- Department of Thyroid Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Key Medicine Laboratory of Thyroid Cancer of Henan Province, Zhengzhou, China
- Engineering Research Center of Multidisciplinary Diagnosis and Treatment of Thyroid Cancer of Henan Province, Zhengzhou, China
- *Correspondence: Detao Yin,
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Zurnadzhy L, Bogdanova T, Rogounovitch TI, Ito M, Tronko M, Yamashita S, Mitsutake N, Chernyshov S, Masiuk S, Saenko VA. The BRAFV600E Mutation Is Not a Risk Factor for More Aggressive Tumor Behavior in Radiogenic and Sporadic Papillary Thyroid Carcinoma at a Young Age. Cancers (Basel) 2021; 13:cancers13236038. [PMID: 34885148 PMCID: PMC8656579 DOI: 10.3390/cancers13236038] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/26/2021] [Accepted: 11/29/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Analysis of the groups of young Ukrainian patients (aged ≤28 years) with radiogenic and sporadic papillary thyroid carcinomas (PTCs) showed that the frequency of BRAFV600E was increasing with patient age, consistently remaining lower in radiogenic PTCs. In both etiopathogenic groups, the BRAFV600E-positive PTCs more frequently had a dominant papillary growth pattern, smaller tumor size, higher Ki67 labeling index, and a frequency of the major indicators of tumor invasiveness that is lower than or equal to that of the BRAFV600E-negative tumors. Comparison of the BRAFV600E-positive PTCs across the groups found a virtual absence of differences, while the BRAFV600E-negative tumors differed markedly and displayed a higher frequency of invasive tumor features in the radiogenic PTCs. Hence, there is evidence that BRAFV600E does not confer a more aggressive course of PTC in young patients regardless of tumor etiology. Abstract Histopathological changes in the fusion oncogene-driven papillary thyroid carcinomas (PTCs) from children and adolescents exposed to Chernobyl fallout have been extensively studied. However, characteristics of the radiogenic BRAFV600E-positive PTCs, whose proportion is growing with time, are not well described yet. We analyzed the relationship between the BRAFV600E status (determined immunohistochemically with the VE1 antibody) and the clinicopathological features of 247 radiogenic and 138 sporadic PTCs from young Ukrainian patients aged ≤28 years. The frequency of BRAFV600E was increasing with patient age, consistently remaining lower in radiogenic PTCs. In both etiopathogenic groups, the BRAFV600E-positive PTCs more frequently had a dominant papillary growth pattern, smaller tumor size, higher Ki67 labeling index, and a frequency of the major indicators of tumor invasiveness that is lower than or equal to that of the BRAFV600E-negative tumors. Comparison of the BRAFV600E-positive PTCs across the groups found a virtual absence of differences. In contrast, the BRAFV600E-negative radiogenic PTCs displayed less frequent dominant papillary and more frequent solid growth patterns, lower Ki67 labeling index, and higher invasiveness than the BRAFV600E-negative sporadic tumors. Thus, BRAFV600E is not associated with a more aggressive course of PTC in young patients regardless of etiology. The major clinicopathological differences between the radiogenic and sporadic PTCs are observed among the BRAFV600E-negative tumors.
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Affiliation(s)
- Liudmyla Zurnadzhy
- State Institution “V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine”, 69 Vyshgorodska Str., 04114 Kyiv, Ukraine; (L.Z.); (T.B.); (M.T.); (S.C.)
- Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan;
| | - Tetiana Bogdanova
- State Institution “V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine”, 69 Vyshgorodska Str., 04114 Kyiv, Ukraine; (L.Z.); (T.B.); (M.T.); (S.C.)
- Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan;
| | - Tatiana I. Rogounovitch
- Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki 852-8523, Japan;
- Correspondence: ; Tel.: +81-(0)95-819-7116
| | - Masahiro Ito
- Nagasaki Medical Center, 2-1001-1 Kubara, Omura 856-8562, Japan;
| | - Mykola Tronko
- State Institution “V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine”, 69 Vyshgorodska Str., 04114 Kyiv, Ukraine; (L.Z.); (T.B.); (M.T.); (S.C.)
| | - Shunichi Yamashita
- Fukushima Medical University, Hikarigaoka 1, Fukushima 960-1295, Japan;
- National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Chiba 263-8555, Japan
| | - Norisato Mitsutake
- Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki 852-8523, Japan;
| | - Serhii Chernyshov
- State Institution “V.P. Komisarenko Institute of Endocrinology and Metabolism of the National Academy of Medical Sciences of Ukraine”, 69 Vyshgorodska Str., 04114 Kyiv, Ukraine; (L.Z.); (T.B.); (M.T.); (S.C.)
| | - Sergii Masiuk
- State Institution “National Research Center for Radiation Medicine of the National Academy of Medical Sciences of Ukraine”, 53 Illienka Str., 04050 Kyiv, Ukraine;
| | - Vladimir A. Saenko
- Department of Radiation Molecular Epidemiology, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan;
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Niciporuka R, Nazarovs J, Ozolins A, Narbuts Z, Miklasevics E, Gardovskis J. Can We Predict Differentiated Thyroid Cancer Behavior? Role of Genetic and Molecular Markers. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:1131. [PMID: 34684168 PMCID: PMC8540789 DOI: 10.3390/medicina57101131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 10/07/2021] [Accepted: 10/15/2021] [Indexed: 12/27/2022]
Abstract
Thyroid cancer is ranked in ninth place among all the newly diagnosed cancer cases in 2020. Differentiated thyroid cancer behavior can vary from indolent to extremely aggressive. Currently, predictions of cancer prognosis are mainly based on clinicopathological features, which are direct consequences of cell and tissue microenvironment alterations. These alterations include genetic changes, cell cycle disorders, estrogen receptor expression abnormalities, enhanced epithelial-mesenchymal transition, extracellular matrix degradation, increased hypoxia, and consecutive neovascularization. All these processes are represented by specific genetic and molecular markers, which can further predict thyroid cancer development, progression, and prognosis. In conclusion, evaluation of cancer genetic and molecular patterns, in addition to clinicopathological features, can contribute to the identification of patients with a potentially worse prognosis. It is essential since it plays a crucial role in decision-making regarding initial surgery, postoperative treatment, and follow-up. To date, there is a large diversity in methodologies used in different studies, frequently leading to contradictory results. To evaluate the true significance of predictive markers, more comparable studies should be conducted.
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Affiliation(s)
- Rita Niciporuka
- Department of Surgery, Riga Stradins University, Pilsonu Street 13, LV-1002 Riga, Latvia; (A.O.); (Z.N.); (J.G.)
- Department of Surgery, Pauls Stradins Clinical University Hospital, Pilsonu Street 13, LV-1002 Riga, Latvia
| | - Jurijs Nazarovs
- Department of Pathology, Pauls Stradins Clinical University Hospital, Pilsonu Street 13, LV-1002 Riga, Latvia;
| | - Arturs Ozolins
- Department of Surgery, Riga Stradins University, Pilsonu Street 13, LV-1002 Riga, Latvia; (A.O.); (Z.N.); (J.G.)
- Department of Surgery, Pauls Stradins Clinical University Hospital, Pilsonu Street 13, LV-1002 Riga, Latvia
| | - Zenons Narbuts
- Department of Surgery, Riga Stradins University, Pilsonu Street 13, LV-1002 Riga, Latvia; (A.O.); (Z.N.); (J.G.)
- Department of Surgery, Pauls Stradins Clinical University Hospital, Pilsonu Street 13, LV-1002 Riga, Latvia
| | - Edvins Miklasevics
- Institute of Oncology, Riga Stradins University, Pilsonu Street 13, LV-1002 Riga, Latvia;
| | - Janis Gardovskis
- Department of Surgery, Riga Stradins University, Pilsonu Street 13, LV-1002 Riga, Latvia; (A.O.); (Z.N.); (J.G.)
- Department of Surgery, Pauls Stradins Clinical University Hospital, Pilsonu Street 13, LV-1002 Riga, Latvia
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Liu S, Liu C, Zhao L, Wang K, Li S, Tian Y, Jiao B, Gui Z, Yu T, Zhang L. A prediction model incorporating the BRAF V600E protein status for determining the risk of cervical lateral lymph node metastasis in papillary thyroid cancer patients with central lymph node metastasis. Eur J Surg Oncol 2021; 47:2774-2780. [PMID: 34483032 DOI: 10.1016/j.ejso.2021.08.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 08/11/2021] [Accepted: 08/25/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Cervical lateral lymph node metastasis (LLNM) is a predictor of poor prognosis for papillary thyroid carcinoma (PTC) patients. However, the risk factors for LLNM remain unclear. The purpose of the study was to examine the risk factors for LLNM and construct a prediction model. METHODS With Ethics Committee approval, a total of 1198 PTC patients were retrospectively included in our study. Univariate and multivariate analyses were performed to explore the relationship between clinicopathological characteristics and LLNM. A nomogram for predicting LLNM in PTC patients with central lymph node metastasis (CLNM) was constructed and validated. RESULTS The negative BRAFV600E protein expression was significantly correlated with positive LLNM status in PTC patients. In PTC patients with CLNM, the number of metastatic central lymph nodes (LNN) ≥ 3 and the ratio of metastatic central lymph nodes (LNR) ≥ 0.565 were found to be significantly associated with positive LLNM status. The nomogram for predicting LLNM risk in PTC patients with CLNM incorporated four risk factors: tumor size, the BRAFV600E protein expression, LNN and LNR. The prediction model showed excellent discrimination, with a C-index of 0.714. CONCLUSIONS The negative BRAFV600E protein expression was more likely to lead to LLNM. LNN ≥3 and LNR ≥0.565 were associated with LLNM risk in PTC patients with CLNM. Our nomogram might assist clinicians in developing individual suitable follow-up strategies for PTC patients with CLNM.
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Affiliation(s)
- Shiyang Liu
- Department of Thyroid and Breast Surgery, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, Hubei Province, 430030, China
| | - Chenguang Liu
- Department of Thyroid and Breast Surgery, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, Hubei Province, 430030, China
| | - Lu Zhao
- Department of Thyroid and Breast Surgery, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, Hubei Province, 430030, China
| | - Kun Wang
- Department of Thyroid and Breast Surgery, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, Hubei Province, 430030, China
| | - Shuyu Li
- Department of Thyroid and Breast Surgery, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, Hubei Province, 430030, China
| | - Yao Tian
- Department of Thyroid and Breast Surgery, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, Hubei Province, 430030, China
| | - Bo Jiao
- Department of Anesthesiology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, Hubei Province, 430030, China
| | - Zhengwei Gui
- Department of Thyroid and Breast Surgery, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, Hubei Province, 430030, China
| | - Tianyao Yu
- Department of Thyroid and Breast Surgery, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, Hubei Province, 430030, China
| | - Lin Zhang
- Department of Thyroid and Breast Surgery, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Wuhan, Hubei Province, 430030, China.
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Association between BRAF V600E mutation and the clinicopathological features in incidental papillary thyroid microcarcinoma: A single-center study in Turkish patients. North Clin Istanb 2020; 7:321-328. [PMID: 33043255 PMCID: PMC7521097 DOI: 10.14744/nci.2020.69586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 02/24/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE: In this study, we evaluated the influences of BRAFV600E mutation on clinicopathological features in incidentally found papillary thyroid microcarcinomas (PTMCs). METHODS: This retrospective cohort study included 72 patients with PTMC who underwent surgery from 2008 to 2012. The mean follow-up of the whole cohort was three years. DNA was isolated using QIAamp DNA formalin-fixed, paraffin-embedded (FFPE) tissue kit. BRAF gene was amplified by the polymerase chain reaction-restriction fragment length (PCR-RFL) polymorphism method with the following primers. The clinicopathologic features (age, gender, histologic subtype, tumor size, presence of tumor capsule, bilaterality, multifocality, extrathyroidal extension (ETE), thyroid capsular invasion, presence of Hashimoto’s thyroiditis, lymph node metastasis (LNM) and distant metastasis) were compared between the BRAF (+) and BRAF (-) patient groups. RESULTS: BRAFV600E mutation was detected in 30 of the 72 patients (41.6%). The presence of the mutation was statistically significantly associated with classic variant (p=0.046), invasion of thyroid capsule (p=0.002) and absence of tumor capsule (p=0.003). CONCLUSION: Although incidental PTMCs positive for the BRAFV600E mutation had more invasive behavior, the presence of the mutation was not associated with recurrences within three years of follow-up.
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10
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Ferrari SM, Fallahi P, Elia G, Ragusa F, Ruffilli I, Paparo SR, Antonelli A. Thyroid autoimmune disorders and cancer. Semin Cancer Biol 2020; 64:135-146. [DOI: 10.1016/j.semcancer.2019.05.019] [Citation(s) in RCA: 84] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 05/24/2019] [Accepted: 05/29/2019] [Indexed: 12/18/2022]
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11
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Vita R, Ieni A, Tuccari G, Benvenga S. The increasing prevalence of chronic lymphocytic thyroiditis in papillary microcarcinoma. Rev Endocr Metab Disord 2018; 19:301-309. [PMID: 30456477 DOI: 10.1007/s11154-018-9474-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Although the incidence of some malignancy has decreased over the recent years, this is not the case of papillary thyroid microcarcinoma (PTMC), whose incidence has increased worldwide. Most PTMC are found incidentally after histological examination of specimens from surgery for benign thyroid disease. Hashimoto's thyroiditis, whose incidence has also increased, coexists in about one in three PTMC patients. Three different mechanisms have been proposed to clarify the association between chronic lymphocytic thyroiditis and PTMC, namely tumor development/growth by: (i) TSH stimulation, (ii) expression of certain proto-oncogenes, (iii) chemokines and other molecules produced by the lymphocytic infiltrate. Whether Hashimoto's thyroiditis protects against lymph node metastasis is debated. Overall, autommune thyroiditis seems to contribute to the favorable prognosis of PTMC. Major limitations of the studies so far performed include: (i) retrospective design, (ii) limited statistical power, (iii) high risk of selection bias, (iv) and predominant Asian ethnicity of patients. Full genetic profiling of both diseases and identification of environmental factors capable to trigger them, as well as well-powered prospective studies on different ethnical groups, may help understand their causal association and why their frequencies are continuing raising.
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Affiliation(s)
- Roberto Vita
- Department of Clinical and Experimental Medicine, University of Messina, Viale Gazzi, 98125, Messina, Italy
| | - Antonio Ieni
- Department of Human Pathology of Adult and Evolutive Age "Gaetano Barresi"-Section of Pathological Anatomy, University of Messina, Viale Gazzi, 98125, Messina, Italy
| | - Giovanni Tuccari
- Department of Human Pathology of Adult and Evolutive Age "Gaetano Barresi"-Section of Pathological Anatomy, University of Messina, Viale Gazzi, 98125, Messina, Italy
| | - Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, Viale Gazzi, 98125, Messina, Italy.
- Master Program on Childhood, Adolescent and Women's Endocrine Health, University of Messina, Viale Gazzi, 98125, Messina, Italy.
- Interdepartmental Program of Molecular & Clinical Endocrinology and Women's Endocrine Health, University Hospital, A.O.U. Policlinico G. Martino, Viale Gazzi, 98125, Messina, Italy.
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12
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Goh X, Lum J, Yang SP, Chionh SB, Koay E, Chiu L, Parameswaran R, Ngiam KY, Loh TKS, Nga ME, Lim CM. BRAF mutation in papillary thyroid cancer-Prevalence and clinical correlation in a South-East Asian cohort. Clin Otolaryngol 2018; 44:114-123. [PMID: 30294871 DOI: 10.1111/coa.13238] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 05/27/2018] [Accepted: 09/29/2018] [Indexed: 01/16/2023]
Abstract
OBJECTIVE BRAF mutation is the commonest mutation seen in papillary thyroid cancer (PTC), but its prevalence and clinical significance vary across countries. We aim to evaluate the prevalence and clinico-pathological correlation of BRAF mutation in PTC patients at our centre. STUDY DESIGN Retrospective cohort study of 75 consecutive archival thyroid specimens, whereby BRAF mutation was detected using a polymerase chain reaction (PCR) technique and correlated with clinical and pathological features and outcomes. SETTING Tertiary university hospital in Singapore. PARTICIPANTS A total of 75 consecutive histologically proven archival thyroid specimens from patients who underwent thyroidectomy for PTC were accrued for this study. MAIN OUTCOME MEASURES Main outcome is to determine the prevalence of the BRAF mutation in our South-East Asian population. Secondary aim is to correlate the mutational status with adverse pathological features like histological variants, multi-focality, lymphovascular invasion and extra-thyroidal extension, clinical features like demographics, TNM stage, recurrence and survival, as well as treatment details like type of surgery performed and radioiodine doses. RESULTS BRAF mutation was detected in 56% (42/75) of PTC. All but one BRAF-mutated PTC had the BRAFV600E mutation. BRAF-mutated tumours were associated with an advanced T-stage (P = 0.049) and were more likely to have a central neck dissection (P = 0.036). There was no significant correlation between BRAF mutation status and clinical outcomes. CONCLUSION The prevalence of BRAF mutation is 56%. BRAF mutation-positive tumours were associated with locally advanced disease, but not poorer survival.
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Affiliation(s)
- Xueying Goh
- Department of Otolaryngology - Head and Neck Surgery, National University Hospital, Singapore
| | - Jeffery Lum
- Department of Pathology, National University Hospital, Singapore
| | - Samantha Peiling Yang
- Division of Endocrinology, University Medicine Cluster, National University Hospital, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Siok Bee Chionh
- Division of Endocrinology, University Medicine Cluster, National University Hospital, Singapore
| | - Evelyn Koay
- Department of Pathology, National University Hospital, Singapore.,Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of Laboratory Medicine, National University Hospital, Singapore
| | - Lily Chiu
- Department of Laboratory Medicine, National University Hospital, Singapore
| | - Rajeev Parameswaran
- Division of General Surgery, University Surgical Cluster, National University Hospital, Singapore
| | - Kee Yuan Ngiam
- Division of General Surgery, University Surgical Cluster, National University Hospital, Singapore
| | - Thomas Kwok Seng Loh
- Department of Otolaryngology - Head and Neck Surgery, National University Hospital, Singapore.,Department of Otolaryngology - Head and Neck Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Min En Nga
- Department of Pathology, National University Hospital, Singapore.,Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chwee Ming Lim
- Department of Otolaryngology - Head and Neck Surgery, National University Hospital, Singapore.,Department of Otolaryngology - Head and Neck Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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13
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Huang L, Wang X, Huang X, Gui H, Li Y, Chen Q, Liu D, Liu L. Diagnostic significance of CK19, galectin-3, CD56, TPO and Ki67 expression and BRAF mutation in papillary thyroid carcinoma. Oncol Lett 2018. [PMID: 29541194 PMCID: PMC5835856 DOI: 10.3892/ol.2018.7873] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The aim of the present study was to examine the rate of BRAF mutation and the expression profiles of CK19, galectin-3, CD56, thyroid peroxidase (TPO) and Ki67 in papillary thyroid carcinoma (PTC) and papillary thyroid micro-carcinoma (PTMC). A total of 246 cases of thyroid disease were collected, including PTC, PTMC, nodular goiter (NG) and Hashimoto thyroiditis (HT). The results revealed that CK19 expression was 116/120 in PTC, 61/64 in PTMC, 2/34 in NG and 1/28 in HT. Galectin-3 positive expression was 115/120 in PTC, 60/64 in PTMC, 6/34 in NG and 4/28 in HT. TPO positive expression was 8/120 in PTC, 1/64 in PTMC, 30/34 in NG and 25/28 in HT. CD56-positive expression was 12/120 in PTC, 3/64 in PTMC, 33/34 in NG and 26/28 in HT. Ki67 labeling index was 2.52±0.46% in PTC (120 cases), 2.62±0.52% in PTMC (64 cases), 2.55±0.44% in NG (34 cases) and 2.58±0.48% in HT (28 cases). BRAF mutation rate was 93/120 in PTC, 47/64 in PTMC, 3/34 in NG and 2/28 in HT. These results suggested that expression patterns of CK19, galectin-3, CD56 and TPO and BRAF mutation exhibit diagnosis value in thyroid disease. However, Ki67-positive rate exhibits no notable diagnosis value in thyroid disease.
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Affiliation(s)
- Lihua Huang
- Department of Pathology, Wuhan Puai Hospital, Wuhan, Hubei 430030, P.R. China
| | - Xuming Wang
- Department of Histopathology, Jiangda Pathology Institute, Jianghan University, Wuhan, Hubei 430056, P.R. China.,Department of Pathology and Pathophysiology, School of Medicine, Jianghan University, Wuhan, Hubei 430056, P.R. China
| | - Xuan Huang
- Department of Histopathology, Jiangda Pathology Institute, Jianghan University, Wuhan, Hubei 430056, P.R. China.,Department of Pathology and Pathophysiology, School of Medicine, Jianghan University, Wuhan, Hubei 430056, P.R. China
| | - Huawei Gui
- Department of Pathology, Wuhan Puai Hospital, Wuhan, Hubei 430030, P.R. China
| | - Yan Li
- Department of Histopathology, Jiangda Pathology Institute, Jianghan University, Wuhan, Hubei 430056, P.R. China.,Department of Pathology and Pathophysiology, School of Medicine, Jianghan University, Wuhan, Hubei 430056, P.R. China
| | - Qiongxia Chen
- Department of Histopathology, Jiangda Pathology Institute, Jianghan University, Wuhan, Hubei 430056, P.R. China.,Department of Pathology and Pathophysiology, School of Medicine, Jianghan University, Wuhan, Hubei 430056, P.R. China
| | - Dongling Liu
- Department of Pathology, Wuhan Puai Hospital, Wuhan, Hubei 430030, P.R. China
| | - Lijiang Liu
- Department of Histopathology, Jiangda Pathology Institute, Jianghan University, Wuhan, Hubei 430056, P.R. China.,Department of Pathology and Pathophysiology, School of Medicine, Jianghan University, Wuhan, Hubei 430056, P.R. China
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14
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Rodrigues AC, Penna G, Rodrigues E, Castro P, Sobrinho-Simões M, Soares P. The Genetics of Papillary Microcarcinomas of the Thyroid: Diagnostic and Prognostic Implications. Curr Genomics 2017; 18:244-254. [PMID: 28659720 PMCID: PMC5476952 DOI: 10.2174/1389202918666170105094459] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/03/2016] [Accepted: 11/05/2016] [Indexed: 01/11/2023] Open
Abstract
Papillary microcarcinoma of the thyroid (mPTC) is defined by the WHO as a papillary thy-roid cancer measuring 10mm or less in diameter and it is nowadays a topic of intense debate among the members of the medical community due to its apparent “epidemic” rise. Although these tumors follow almost always an indolent clinical course and carry an excellent prognosis, it is known that a small sub-set may display a potentially aggressive behavior. Nevertheless, we still lack an accurate way of predict-ing those which will cause significant disease. In an attempt to address this problem, a number of clini-co-pathologic features have been studied as poor prognostic markers in mPTC, and their association with known genetic alterations in thyroid cancer has been evaluated. Herein we review the present knowledge concerning mPTC’s genetic profile, namely the prevalence of BRAF (V600E), RAS and TERT promoter mutations and RET/PTC and PAX8-PPARG rearrangements and report the results of the evaluation in the putative prognostic value of these genetic alterations in mPTC.
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Affiliation(s)
- Ana Cunha Rodrigues
- Department of Pathology, Medical Faculty, University of Porto, Porto, Portugal
| | - Gustavo Penna
- Department of Internal Medicine - Endocrinology, Medical Faculty, Federal University of Rio de Janeiro, Rio de Janeiro, Brasil
| | - Elisabete Rodrigues
- Department of Endocrinology, Medical Faculty, University of Porto, Porto, Portugal
| | - Patrícia Castro
- Instituto de Investigação e Inovação em Saúde (I3S), Universidade do Porto, Porto, Portugal.,Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal
| | - Manuel Sobrinho-Simões
- Department of Pathology, Medical Faculty, University of Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde (I3S), Universidade do Porto, Porto, Portugal.,Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal.,Department of Pathology, Hospital de S. João, Porto, Portugal
| | - Paula Soares
- Department of Pathology, Medical Faculty, University of Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde (I3S), Universidade do Porto, Porto, Portugal.,Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Porto, Portugal
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15
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Ieni A, Barresi V, Cardia R, Licata L, Di Bari F, Benvenga S, Tuccari G. The micropapillary/hobnail variant of papillary thyroid carcinoma: A review of series described in the literature compared to a series from one southern Italy pathology institution. Rev Endocr Metab Disord 2016; 17:521-527. [PMID: 27896649 DOI: 10.1007/s11154-016-9398-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Papillary thyroid carcinoma (PTC) has a good prognosis with a 10-yr survival greater than 90%. Recently, a micro-papillary pattern with hobnail appearance (MPHC) in PTC has been indicated as associated with poor prognosis, but this suggestion is based only on a few cases from geographical areas different from ours. Two-hundred ninety-nine consecutive PTC cases were collected between the years of 1992 and 2014 at our institution. The corresponding histologic sections (at least 6 for each case) were stained with hematoxylin and eosin and reviewed independently by two pathologists to reach a consensus on the identification and quantification of the MPHC. As done in other cohorts, parallel serial sections were stained with antisera for thyroglobulin, epithelial membrane antigen, thyroid-transcription-factor-1 and Ki 67. BRAF gene mutation at codon 600 and RET/PTC1 gene rearrangements were searched. A comparative statistical analysis was done between the present series and previously published series. Of the 295 PTC, 124 (42.5%) were follicular, 104 (35%) classic, 34 (11.5%) sclerosing, 15 (5%) tall cells, 10 (3.4%) Warthin-like, and 8 (2.7%) MPHC. Four MHPC cases (50%) harbored the BRAF V600E variant, while one was positive for RET/PTC1 rearrangement. Our rate of MPHC-PTC (2.7%) is 2X to 8X greater than those reported previously for cohorts from North America + North Italy, Korea and Mexico. MPHC prognosis appears to be better compared to other cohorts, probably due to not only to the lower rate of the vascular invasion, but also to the smaller size of the MPHC-PTC nodule.
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Affiliation(s)
- Antonio Ieni
- Department of Human Pathology "Gaetano Barresi" - Section of Pathological Anatomy, A.O.U. Polyclinic G.Martino, 98125, Messina, Italy.
| | - Valeria Barresi
- Department of Human Pathology "Gaetano Barresi" - Section of Pathological Anatomy, A.O.U. Polyclinic G.Martino, 98125, Messina, Italy
| | - Roberta Cardia
- Department of Human Pathology "Gaetano Barresi" - Section of Pathological Anatomy, A.O.U. Polyclinic G.Martino, 98125, Messina, Italy
| | - Luana Licata
- Department of Human Pathology "Gaetano Barresi" - Section of Pathological Anatomy, A.O.U. Polyclinic G.Martino, 98125, Messina, Italy
| | - Flavia Di Bari
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
- Master Program on Childhood, Adolescent and Women's Endocrine Health, University of Messina, Messina, Italy
- Interdepartmental Program of Molecular & Clinical Endocrinology and Women's Endocrine Health, University Hospital, A.O.U. Policlinico G. Martino, Messina, Italy
| | - Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
- Master Program on Childhood, Adolescent and Women's Endocrine Health, University of Messina, Messina, Italy
- Interdepartmental Program of Molecular & Clinical Endocrinology and Women's Endocrine Health, University Hospital, A.O.U. Policlinico G. Martino, Messina, Italy
| | - Giovanni Tuccari
- Department of Human Pathology "Gaetano Barresi" - Section of Pathological Anatomy, A.O.U. Polyclinic G.Martino, 98125, Messina, Italy
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16
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Hirokawa M, Kudo T, Ota H, Suzuki A, Miyauchi A. Pathological characteristics of low-risk papillary thyroid microcarcinoma with progression during active surveillance. Endocr J 2016; 63:805-810. [PMID: 27397594 DOI: 10.1507/endocrj.ej16-0097] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Papillary thyroid microcarcinoma (PTMC) is generally an indolent disease and active surveillance is conducted for low-risk cases. This study was carried out to clarify the pathological characteristics of PTMC cases that exhibited enlarged nodules or nodal metastasis during the surveillance period. A total of 188 PTMC cases that underwent surgery after active surveillance for ≥ 1 year were examined. Ki-67 labeling indices of > 5% and > 10% were detected in 50.0% and 22.2% of enlarged cases, respectively, values that were significantly higher than those in non-enlarged cases. Intraglandular dissemination and psammoma bodies in normal thyroid tissue were associated with new occurrence of nodal metastasis. Ultrasonographic macrocalcification and follicular variants were observed in 13.8% and 10.6% of non-enlarged cases, respectively, but not in enlarged or nodal metastatic cases. Intraglandular dissemination and psammoma bodies were ultrasonographically detected in 50.0% and 40.0% of cases, which was confirmed by microscopy. Thus, high Ki-67 labeling index, intraglandular metastasis, and psammoma bodies in normal thyroid tissue are indicators of progressive PTMC, and may be identified cytologically or ultrasonographically. In PTMC cases with ultrasonographic macrocalcification, active surveillance can be proactively implemented.
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