Matias-Guiu X, Villanueva A, Cuatrecasas M, Capella G, De Leiva A, Prat J
Department of Pathology, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Spain.
Pathol Res Pract. 1996 Dec;192(12):1242-9; discussion 1250-1. doi: 10.1016/S0344-0338(96)80159-2.
The clinical and pathologic features of a rare case of follicular carcinoma with small foci of poorly differentiated and anaplastic carcinoma are presented. Eight years after the removal of the primary neoplasm, the patient developed pulmonary and brain metastases that were predominantly composed of the poorly differentiated and anaplastic components. A comparative immunohistochemical and molecular analysis of p53 status in the follicular, poorly differentiated and anaplastic components of the tumor was performed. p53 immunostaining was restricted to the poorly differentiated and anaplastic areas. Single strand conformation polymorphism analysis (SSCP-PCR) from DNA obtained by microdissection demonstrated the presence of a mutation (TAT-->TGT; Tyr-->Cys) in codon 220, exon six of the p53 gene in the anaplastic component, that was absent in the well-differentiated follicular areas. The results of that study in this rare tumor support that p53 has a tumor progression role in thyroid tumorigenesis.
本文报告了一例罕见的滤泡癌合并小灶低分化及未分化癌的临床和病理特征。原发性肿瘤切除八年后,患者出现肺和脑转移,转移灶主要由低分化和未分化成分组成。对肿瘤的滤泡、低分化和未分化成分进行了p53状态的免疫组化和分子对比分析。p53免疫染色仅限于低分化和未分化区域。通过显微切割获得的DNA进行单链构象多态性分析(SSCP-PCR)显示,未分化成分中p53基因第六外显子220密码子存在突变(TAT→TGT;酪氨酸→半胱氨酸),而高分化滤泡区域不存在该突变。对这种罕见肿瘤的研究结果支持p53在甲状腺肿瘤发生中具有肿瘤进展作用。