Milman Sofiya, Arnold Jeffrey L, Price Melissa, Negassa Abdissa, Surks Martin I, Fleischer Norman, Whitney Kathleen D
Endocr Pract. 2015 Jun;21(6):590-4. doi: 10.4158/EP14357.OR. Epub 2015 Feb 25.
Presently, no clinical tools are available to diagnose the metastatic potential of medullary thyroid cancer (MTC) at disease presentation. Surveillance with calcitonin (Ct) and carcinoembryonic antigen (CEA) is currently recommended for the observation and diagnosis of metastatic disease after initial treatment of MTC. Recently, carbohydrate antigen (CA)19-9 staining has been associated with aggressive forms of MTC and metastatic spread. This pilot study explored whether positive CA19-9 staining of MTC tissue is associated with its metastatic potential.
Sixteen cases of MTC were identified, and tissue specimens were immunostained for CA 19-9 and other MTC tumor markers. Clinical information about patients' MTC was collected through a retrospective chart review.
Overall, 63% of the specimens stained positive for CA19-9. The median size of positively staining specimens was 2.6 cm (interquartile range [IQR] 1.2-3.2) compared to 0.7 cm (0.5-1.2) in negatively staining MTC specimens (P = .04). All specimens from patients diagnosed with stage IV MTC stained positive for CA19-9, compared to only 40% of cases that were classified as stages I to III (P = .03). Furthermore, 100% of the primary specimens that were documented to have metastatic spread stained positive for CA19-9. The sensitivity for ruling out stage IV MTC based on negative staining for CA 19-9 was 100%.
Based on these results, we conclude that negative staining of MTC for CA19-9 may be associated with its decreased metastatic potential.
目前，在髓样甲状腺癌（MTC）疾病呈现时，尚无临床工具可用于诊断其转移潜能。目前推荐使用降钙素（Ct）和癌胚抗原（CEA）进行监测，以观察和诊断MTC初始治疗后的转移性疾病。最近，糖类抗原（CA）19-9染色已与侵袭性MTC形式和转移扩散相关联。这项初步研究探讨了MTC组织中CA19-9染色阳性是否与其转移潜能相关。
确定了16例MTC病例，并对组织标本进行CA 19-9和其他MTC肿瘤标志物的免疫染色。通过回顾性病历审查收集了患者MTC的临床信息。
总体而言，63%的标本CA19-9染色呈阳性。阳性染色标本的中位大小为2.6 cm（四分位间距[IQR] 1.2 - 3.2），而阴性染色的MTC标本为0.7 cm（0.5 - 1.2）（P = 0.04）。所有诊断为IV期MTC患者的标本CA19-9染色均为阳性，而I至III期病例中只有40%（P = 0.03）。此外，有转移扩散记录的原发标本中100%的CA19-9染色呈阳性。基于CA 19-9阴性染色排除IV期MTC的敏感性为100%。
基于这些结果，我们得出结论，MTC的CA19-9阴性染色可能与其转移潜能降低相关。
