P53、E-钙黏蛋白和 BRAF 作为预测甲状腺乳头状癌区域淋巴结复发的标志物。
Role of P53, E-cadherin and BRAF as predictors of regional nodal recurrence for papillary thyroid cancer.
机构信息
Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Surgical Oncology, Oncology Centre Mansoura University, Mansoura, Egypt.
出版信息
Ann Diagn Pathol. 2019 Jun;40:59-65. doi: 10.1016/j.anndiagpath.2019.04.005. Epub 2019 Apr 16.
BACKGROUND
Regional nodal recurrence (RNR) in patients diagnosed with papillary thyroid carcinoma (PTC) has increased. Variable immunohistochemical (IHC) markers have been studied for predicting the likelihood of PTC for recurrence. We aimed to clarify the IHC expression of p53, Ecadherin and BRAF as potential markers of RNR in PTC.
METHOD
145 (73 study group and 72 control group) patients with PTC were analyzed retrospectively between January 2010 and June 2017. Further classification to a specific histological variant was done, and IHC expression of p53, Ecadherin and BRAF was analyzed both in the primary tumor and in nodal recurrence.
RESULTS
Regarding the risk of RNR, we found certain clinicopathologic features as elder age ≥55 years, tumor size >1 cm, presence of microscopic extrathyroid extension, presence of lymphovascular emboli, and conventional papillary subtype. Furthermore, IHC results for negative E-cadherin, and positive P53 and BRAF are significant risk factors, while radioactive iodine (RAI) adjuvant therapy decrease recurrence risk.
CONCLUSION
We found several risk factors for RNR in PTC diagnosed patients, all of which are easily achievable in clinical settings. In this regard, we suggested that patients with specific clinicopathologic and immunohistochemical features have strict follow up for early detection of RNR as it has a great impact on their survival.
背景
诊断为甲状腺乳头状癌（PTC）的患者区域淋巴结复发（RNR）有所增加。已经研究了各种免疫组织化学（IHC）标志物来预测 PTC 复发的可能性。我们旨在阐明 p53、E-钙粘蛋白和 BRAF 的 IHC 表达作为 PTC RNR 的潜在标志物。
方法
回顾性分析了 2010 年 1 月至 2017 年 6 月间的 145 例（73 例研究组和 72 例对照组）PTC 患者。进一步进行了特定组织学变异的分类，并分析了原发性肿瘤和淋巴结复发中 p53、E-钙粘蛋白和 BRAF 的 IHC 表达。
结果
关于 RNR 的风险，我们发现某些临床病理特征，如年龄≥55 岁、肿瘤大小>1cm、存在显微镜下甲状腺外扩展、存在淋巴血管内栓塞以及传统的乳头型亚型。此外，E-钙粘蛋白阴性和 p53、BRAF 阳性的 IHC 结果是显著的危险因素，而放射性碘（RAI）辅助治疗降低了复发风险。
结论
我们发现了一些 PTC 患者 RNR 的危险因素，所有这些危险因素在临床实践中都很容易实现。在这方面，我们建议具有特定临床病理和免疫组织化学特征的患者进行严格的随访，以早期发现 RNR，因为这对他们的生存有重大影响。
Zotero 插件