Chang Jeremy, Alzayadneh Eyas M, Rajan Anand, Tran Andy, Weigel Ronald J, Beck Anna C
Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
Department of Pathology, University of Virginia, Charlottesville, VA, USA.
Ann Surg Oncol. 2025 Apr 11. doi: 10.1245/s10434-025-17256-2.
Molecular profiling has refined the identification of pathologic subtypes in other cancers, but is not currently used for prognostication in papillary thyroid cancer (PTC). The cancer stem cell marker, CD133, is a glycoprotein associated with tumor initiation and radioresistance in PTC, but its role in prognostication continues to be defined. This study sought to define the association between CD133 expression in PTC and recurrence-free survival (RFS).
All the patients at a single institution with PTC who underwent thyroidectomy from 2008 to 2011 were identified through an electronic medical record query. Immunohistochemistry was performed for CD133, and the H-score was calculated. Receive operating characteristic (ROC) curves were used to identify the optimal cutoff for CD133 expression.
Overall, 110 consecutive patients were identified, and 12% had a biopsy-proven recurrence during a median follow-up period of 10.1 years (interquartile range [IQR], 8.3-11.5 years). The median H-score did not differ significantly between the patients who experienced recurrence (74; IQR, 59-81) and those who did not (70; IQR, 51-89). An H-score of 55 or higher identified patients who had a recurrence with 92% sensitivity. Among the patients with a CD133 H-score of 55 or higher, males had a significantly worse RFS than females (p = 0.005), but RFS did not differ between males and females with a CD133 H-score lower than 55 (p = 0.739).
A clear role of CD133 in prognostication has not been defined to date. Expression of CD133 and its association with survival varies between males and females, with stratification of recurrence risk more prominent in males.
分子谱分析已优化了其他癌症病理亚型的识别，但目前尚未用于甲状腺乳头状癌（PTC）的预后评估。癌症干细胞标志物CD133是一种与PTC肿瘤起始和放射抵抗相关的糖蛋白，但其在预后评估中的作用仍有待明确。本研究旨在明确PTC中CD133表达与无复发生存期（RFS）之间的关联。
通过电子病历查询确定了2008年至2011年在单一机构接受甲状腺切除术的所有PTC患者。对CD133进行免疫组织化学检测，并计算H评分。采用受试者工作特征（ROC）曲线确定CD133表达的最佳临界值。
总体而言，共确定了110例连续患者，在中位随访期10.1年（四分位间距[IQR]，8.3 - 11.5年）期间，12%的患者经活检证实复发。复发患者的中位H评分（74；IQR，59 - 81）与未复发患者（70；IQR，51 - 89）之间无显著差异。H评分为55或更高可识别出复发患者，敏感性为92%。在CD133 H评分为55或更高的患者中，男性的RFS明显比女性差（p = 0.005），但CD133 H评分低于55的男性和女性之间的RFS无差异（p = 0.739）。
迄今为止，CD133在预后评估中的明确作用尚未确定。CD133的表达及其与生存的关联在男性和女性之间有所不同，男性的复发风险分层更为突出。
