Division of Anatomic Pathology and Histology, Catholic University of Sacred Hearth, Rome, Italy.
Division of Endocrinology, Catholic University, Rome, Italy.
Cancer Cytopathol. 2023 Jun;131(6):392-401. doi: 10.1002/cncy.22694. Epub 2023 Mar 27.
TP53 gene plays a major role in the negative control of cell proliferation and in the regulation of signaling cascades. TP53 mutation may have a relevant role in the malignant transformation of thyroid cells as well as thyroid tumor progression. TP53 mutation has been detected only in few well differentiated thyroid carcinomas and is absent in benign conditions.
A total of 162 prospective thyroid cytology and corresponding histological samples diagnosed from atypia of indeterminate significance (AUS) to malignant, were studied via immunocytochemistry for p53. Hence, 50 benign lesions (B) were used as negative control. Molecular analysis for p53 only was performed.
The cytology resulted in 50 B, 48 AUS, 40 follicular neoplasms (FNs), 23 suspicious for malignancy (SFM), and 1 malignant (M) case. The authors reported 102 negative and 60 positive p53 cases. The 60 positive cases included 27 cases with weak and/or focal cytoplasmic positivity (+1) and 33 with cases moderate (2+) to strong (3+) cytoplasmic and/or nuclear expression. Overall, 71 cases had histology (2 B, 11 AUS, 37 FN, 20 SFM, and 1 M) including 61.7% benign and 38.2% malignant diagnoses. Only 16 of 71 (5 FN, 10 SFM, and 1 M) were p53-positive. Furthermore, 100% AUS and 86.5% FN cases were p53-negative, none of which had malignant histology. All p53-positive cases were associated with a larger nodule size, tall-cell variant subtype, multifocality, extra thyroidal infiltration, and nodal metastases. Noninvasive follicular thyroid neoplasm with papillary like nuclear features were negative for p53. Few discrepancies in p53 intensity were observed on histology; there were no differences with the molecular testing.
p53 might be useful in discriminating thyroid follicular lesions. p53 is likely to be a useful diagnostic marker in recognizing indeterminate lesions that are well-differentiated thyroid cancers.
TP53 基因在细胞增殖的负调控和信号级联的调节中起着重要作用。TP53 突变可能在甲状腺细胞的恶性转化以及甲状腺肿瘤的进展中起重要作用。TP53 突变仅在少数分化良好的甲状腺癌中被检测到，而在良性情况下不存在。
通过免疫细胞化学法对 p53 进行检测，对从不确定意义的非典型性（AUS）到恶性的 162 例甲状腺细胞学和相应的组织学标本进行了研究。因此，使用 50 例良性病变（B）作为阴性对照。仅进行 p53 的分子分析。
细胞学结果为 50 例 B、48 例 AUS、40 例滤泡性肿瘤（FN）、23 例疑似恶性（SFM）和 1 例恶性（M）。作者报告了 102 例阴性和 60 例阳性 p53 病例。60 例阳性病例中，有 27 例表现为弱且/或局灶性细胞质阳性（+1），33 例表现为中等（2+）至强（3+）的细胞质和/或核表达。总体而言，有 71 例组织学（2 例 B、11 例 AUS、37 例 FN、20 例 SFM 和 1 例 M），包括 61.7%良性和 38.2%恶性诊断。只有 16 例（5 例 FN、10 例 SFM 和 1 例 M）为 p53 阳性。此外，100%的 AUS 和 86.5%的 FN 病例为 p53 阴性，无恶性组织学。所有 p53 阳性病例均与较大的结节大小、高细胞变异型亚型、多灶性、甲状腺外浸润和淋巴结转移有关。无侵袭性滤泡性甲状腺肿瘤伴乳头状核特征的 p53 为阴性。在组织学上观察到 p53 强度的一些差异；与分子检测没有差异。
p53 可能有助于鉴别甲状腺滤泡性病变。p53 可能是识别分化良好的甲状腺癌的不确定病变的有用诊断标志物。
