INSERM U624 Stress Cellulaire, Parc Scientifique et Technologique de Luminy, Case 915, 13288, Marseille, France.
World J Surg. 2010 Apr;34(4):830-5. doi: 10.1007/s00268-010-0395-6.
Medullary thyroid cancer (MTC) is characterized by early regional lymph node metastasis, the presence of which represents a critical obstacle to cure. At present no molecular markers have been successfully integrated into the clinical care of sporadic MTC. The present study was designed to evaluate TP53INP1 expression in MTC and to assess its ability to guide the surgeon to the optimal extent of surgery performed with curative intent.
Thirty-eight patients with sporadic MTC were evaluated. TP53INP1 immunoexpression was studied on embedded paraffin material and on cytological smears.
TP53INP1 was expressed in normal C cells, in C-cell hyperplasia, and in 57.9% of MTC. It was possible to identify two groups of MTC according to the proportion of TP53INP1 expressing tumor cells: group 1 from 0% to <50% and group 2 from 50% to 100% of positive cells. Patients with a decreased expression of TP53INP1 (group 1) had a lower rate of nodal metastasis (18.8% versus 63.4% in group 2; P = 0.009), with only minimal lymph node involvement per N1 patient (2.7% of positive lymph nodes versus 22.9%; P < 0.001) and better outcomes (100% of biochemical cure versus 55.5%; P < 0.001). Patients with distant metastases were only observed in group 2. Cytological samples exhibit similar results to their embedded counterparts.
TP53INP1 immunoexpression appears to be a clinical predictor of lymph node metastasis in MTC. The evaluation of TP53INP1 expression may guide the extent of lymph node dissection in the clinically node-negative neck. These findings require prospective validation.
甲状腺髓样癌（MTC）的特征是早期区域淋巴结转移，存在淋巴结转移是影响其治愈的关键障碍。目前，尚无分子标志物成功整合到散发性 MTC 的临床治疗中。本研究旨在评估 MTC 中 TP53INP1 的表达，并评估其指导外科医生进行具有治愈意图的最佳手术范围的能力。
评估了 38 例散发性 MTC 患者。研究了嵌入石蜡材料和细胞学涂片上的 TP53INP1 免疫表达。
TP53INP1 在正常 C 细胞、C 细胞增生和 57.9%的 MTC 中表达。根据表达 TP53INP1 的肿瘤细胞比例，可以将 MTC 分为两组：组 1 为 0%至 <50%，组 2 为 50%至 100%。TP53INP1 表达减少的患者（组 1）淋巴结转移率较低（18.8%对组 2的 63.4%；P = 0.009），每位 N1 患者的淋巴结受累程度也较低（阳性淋巴结的 2.7%对 22.9%；P < 0.001），且结局更好（生化治愈率为 100%对 55.5%；P < 0.001）。只有组 2 中观察到远处转移的患者。细胞学样本与它们的嵌入样本具有相似的结果。
TP53INP1 免疫表达似乎是 MTC 淋巴结转移的临床预测因子。TP53INP1 表达的评估可能指导临床阴性颈部淋巴结清扫的范围。这些发现需要前瞻性验证。
