Laboratory of Cancer Molecular Genetics, Faculty of Medical Sciences (FCM), University of Campinas (Unicamp), 126, Tessalia Vieira de Camargo St., Barão Geraldo, Campinas, 13083-970, São Paulo, Brazil.
Endocr Pathol. 2013 Jun;24(2):77-82. doi: 10.1007/s12022-013-9245-z.
Although there are evidences of the involvement of KAP-1 in other tumors, data on differentiated thyroid carcinomas (DTC) are still lacking. We aimed to evaluate KAP-1 clinical utility in the diagnosis and prognosis of DTC. We used both visual immunohistochemistry and a semiquantitative analysis to evaluate KAP-1 expression in 230 thyroid carcinomas and 131 noncancerous thyroid nodules. There were 43 follicular carcinomas (FC) and 187 papillary thyroid carcinomas (PTC), including 130 classic (CPTC), 4 tall cells (TCPTC), and 53 follicular variants (FVPTC). Patients were followed up for 53.8 ± 41 months. They were classified as free-of-disease (142 cases) or poor outcome (25 cases--10 deaths), according to their serum Tg levels and image evidences. KAP-1 was identified in 78 % PTC, 75 % TCPTC, 74 % FC, 72 % FVPTC, 55 % FA, 44 % hyperplasia, and 11 % normal thyroid tissues. A ROC analysis identified malignant nodules with 69 % sensitivity and 75 % specificity, using a cutoff of 73.19. In addition to distinguishing benign from malignant thyroid tissues (p < 0.0001), KAP-1 expression differentiated CPTC from nodular hyperplasia (p < 0.0001), CPTC from FA (p = 0.0028), FVPTC from hyperplasia (p = 0.0039), and FC from hyperplasia (p = 0.0025). Furthermore, KAP-1 was more expressed in larger tumors (>4 cm; p = 0.0038) and in individuals who presented recurrences/metastases (p = 0.0130). We suggest that KAP-1 may help diagnose thyroid nodules, characterize follicular-patterned thyroid lesions, and identify individuals with poor prognosis.
尽管有证据表明 KAP-1 参与了其他肿瘤，但关于分化型甲状腺癌 (DTC) 的数据仍然缺乏。我们旨在评估 KAP-1 在 DTC 的诊断和预后中的临床应用价值。我们使用了免疫组织化学的视觉评估和半定量分析，来评估 230 例甲状腺癌和 131 例非癌性甲状腺结节中的 KAP-1 表达。其中有 43 例滤泡状癌 (FC) 和 187 例甲状腺乳头状癌 (PTC)，包括 130 例经典型 (CPTC)、4 例高细胞型 (TCPTC) 和 53 例滤泡状变异型 (FVPTC)。患者的随访时间为 53.8±41 个月。根据他们的血清 Tg 水平和影像学证据，他们被分为无疾病 (142 例) 或不良预后 (25 例--10 例死亡)。KAP-1 在 78%的 PTC、75%的 TCPTC、74%的 FC、72%的 FVPTC、55%的滤泡性腺瘤 (FA)、44%的增生和 11%的正常甲状腺组织中被识别出来。ROC 分析发现，使用 73.19 的截断值，恶性结节的灵敏度为 69%，特异性为 75%。除了区分良性和恶性甲状腺组织 (p<0.0001) 外，KAP-1 的表达还区分了 CPTC 与结节性增生 (p<0.0001)、CPTC 与 FA (p=0.0028)、FVPTC 与增生 (p=0.0039) 和 FC 与增生 (p=0.0025)。此外，KAP-1 在较大的肿瘤 (>4cm；p=0.0038) 和出现复发/转移的个体中表达更高 (p=0.0130)。我们认为 KAP-1 可能有助于诊断甲状腺结节、描述滤泡性甲状腺病变，并识别预后不良的个体。
