Department of Surgery, Sundsvall Hospital, 851 86, Sundsvall, Sweden.
Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77, Stockholm, SE, Sweden.
Sci Rep. 2023 Jan 19;13(1):1070. doi: 10.1038/s41598-023-27684-3.
The clinical significance of thyroglobulin (Tg) expression in papillary thyroid cancer (PTC) has not been systematically explored in relation to the Ki-67 index, lymph node ratio (LNR), or other conventional prognostic predictors. In this retrospective study of 327 patients with PTC, we investigated the immunohistochemical expression of Tg in both primary tumors and their matching lymph node metastases in relation to the Ki-67 index, LNR, and clinical data. Tumoral Tg immunoreactivity was inversely correlated to the Ki-67 index and tumor recurrence. The Ki-67 index was higher in lymph node metastases (mean 4%) than in the primary tumors (mean 3%). Reduced Tg expression, estimated as 0-25% Tg positive tumor cells, was more common in lymph node metastases compared to primary tumors. In addition to advanced metastatic burden (defined as N1b stage and LNR ≥ 21%), low Tg expression (0-25% positive tumor cells) in lymph node metastases had a significant prognostic impact with shorter recurrence-free survival. These findings support the potential value of histopathological assessment of Tg expression and Ki-67 index in lymph node metastases as complementary predictors to anticipate the prognosis of PTC patients better.
在涉及 Ki-67 指数、淋巴结比值 (LNR) 或其他常规预后预测因素时，甲状腺球蛋白 (Tg) 在甲状腺乳头状癌 (PTC) 中的临床意义尚未得到系统探讨。在这项对 327 例 PTC 患者的回顾性研究中，我们研究了原发性肿瘤及其匹配的淋巴结转移中 Tg 的免疫组织化学表达与 Ki-67 指数、LNR 和临床数据的关系。肿瘤 Tg 免疫反应性与 Ki-67 指数和肿瘤复发呈负相关。淋巴结转移中的 Ki-67 指数（平均 4%）高于原发性肿瘤（平均 3%）。与原发性肿瘤相比，淋巴结转移中 Tg 表达减少（估计为 0-25% Tg 阳性肿瘤细胞）更为常见。除了晚期转移负担（定义为 N1b 期和 LNR≥21%）外，淋巴结转移中 Tg 表达（0-25%阳性肿瘤细胞）低与较短的无复发生存期有显著的预后影响。这些发现支持在淋巴结转移中评估 Tg 表达和 Ki-67 指数的组织病理学评估作为补充预测因素的潜在价值，以更好地预测 PTC 患者的预后。
