Clinical significance of RET/PTC and p53 protein expression in sporadic papillary thyroid carcinoma.

Division of Endocrinology, Hospital General i Universitari Vall d'Hebron, Barcelona, Spain.
Histopathology (Impact Factor: 3.3). 02/2007; 50(2):225-31. DOI: 10.1111/j.1365-2559.2006.02555.x
Source: PubMed

ABSTRACT Rearranged during Transfection (RET)/papillary thyroid carcinoma (PTC) and p53 are two genes involved in the pathogenesis of PTC. It has been suggested that RET/PTC expression is associated with higher rates of local extension and lymph node involvement, whereas p53 mutations are more frequent in poorly differentiated and anaplastic carcinomas. In addition, experimental studies have shown that p53 activity can modify the behaviour of PTC carrying RET/PTC. The aim of this study was to investigate the expression of both RET/PTC and p53 in order to evaluate their usefulness as prognostic factors.
Resected specimens of 61 cases of PTC were studied immunohistochemically using a polyclonal antibody to RET and a monoclonal antibody to p53 protein. RET/PTC expression was associated with extrathyroid extension of PTC, at diagnosis (P < 0.05). In contrast, no relationship between p53 immunoreactivity and clinical status was found. In addition, p53 expression was more prevalent among RET/PTC+ patients, and significantly influenced the relationship observed between RET/PTC and extrathyroid extension of the disease.
Our results suggest that immunohistochemistry for both PTC/RET and p53 could be useful in the clinical evaluation of patients with PTC.

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    ABSTRACT: Background: p53 protein expression has been detected immunohistochemically in papillary thyroid carcinoma(PTC). We investigated the relations between its expression and clinicopathologic features and its significance as a diagnostic marker. Materials and Methods: We compared and evaluated 93 patients in whom thyroidectomy with lymph node dissection had been performed to treat PTC for clinicopathologic significance and 102 patients with 23 papillary thyroid overt carcinomas (POC), 57 papillary thyroid microcarcinomas(PMC), 5 follicular adenomas (FA), 5 Hashimoto's thyroiditis (HT) and 12 nodular hyperplasias (NH) for significance as a diagnostic marker. Expression of p53 protein was evaluated immunohistochemically in sections of paraffin- embedded tissue. Results: Statistical analysis showed significantly different expression of p53 in PTC versus other benign thyroid lesions (BTL).The diagnostic sensitivity and specificity were 85.0% and 72.7%, respectively. Overexpression of p53 protein was observed in 44 of the 93 PTC cases (47.3%), but no significant correlation between p53 protein overexpression and clinicopathologic features (age, size, multiplicity, lymph node metastasis, extrathyroidal extension and vascular invasion) was noted. Conclusions: p53 is valuable to distinguish PTC from other BTL, but there is no correlation between p53 protein overexpression and clinicopathologic features.
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    ABSTRACT: Aim: To determine the immunohistochemical expression of CK-19, cErbB2, galectin-3, and p53 in papillary thyroid carcinomas (PTC). Materials and methods: In this study immunohistochemistry was performed on 23 papillary carcinomas (PCs) and 20 papillary microcarcinomas (PMCs). The extents of staining and intensity were scored semiquantitatively. Results: Of the PC cases 56.5% and of the PMC cases 15.0% were stained strongly by cErbB2. The extent of 2+ staining by galectin-3 was 47.8% in PC, whereas it was only 10.0% in PMC (P=0.003). All PMC cases were stained by CK-19 and 21 cases of PC expressed positivity in varying extent of staining. No nuclear immunostaining was detected by p53 in PC and PMC. However, 65.2% of PC and 55.0% of PMC cases showed cytoplasmic reactivity. Conclusion: Both PC and PMC cases showed similar staining extent and intensity by CK-19. This may conclusively help in identifying the papillary carcinoma cases. The majority of PCs stained diffusely and strongly by galectin-3 and expressed strong reaction by cErbB2, which might suggest a relation with the size of the tumor as PMCs stained less diffusely and strongly. As no nuclear staining was detected by p53 in 43 papillary carcinomas, we support the idea that p53 expression is a late event in thyroid carcinogenesis. Papiller tiroid karsinomlarında CK-19, cErb B2, galectin-3 ve p53 ekspresyonu Amaç: Bu çalışmada papiller tiroid karsinomlarında CK-19, cErbB2, galectin-3 ve p53 ekspresyonu araştırıldı. Yöntem ve gereç: Çalışmaya dahil edilen 23 papiller karsinom (PK) ve 20 papiller mikrokarsinom (PMK) olgusuna immünhistokimya uygulandı. Boyanma yaygınlığı ve yoğunluğu semikantitatif olarak değerlendirildi. Bulgular: PK olgularının % 56,5' i ve PMK olgularının % 15,0' i cErbB2 ile güçlü immünreaksiyon gösterdi. Galectin-3 ile PK olgularının % 47,8' inde boyanma yaygınlığı skoru 2+ iken, PMK olgularında bu oran % 10,0 idi (P = 0,003). PMK olgularının tamamı ile PK olgularının 21' inde değişken yaygınlıkta CK-19 ekspresyonu gözlendi. p53 ile nükleer boyanma saptanmazken PK olgularının % 65,2'sinde ve PMK olgularının % 55,0'inde sitoplazmik immünreaksiyon gözlendi. Sonuç: Hem PK hem de PMK olgularının benzer yaygınlık ve yoğunlukta CK-19 ekspresyonu göstermesi, papiller karsinomun saptanmasında bu markırın yardımcı olabileceğini düşündürür. PK olgularının çoğunluğunda yaygın ve güçlü galectin-3 ekspresyonu, cErbB2 ile bu olguların güçlü immünreaksiyon göstermesi ve PMK olgularında daha az yaygın olan zayıf boyanma, bu boyanmaların tümör boyutu ile ilişkili olabileceğini akla getirir. Toplam 43 papiller karsinomun hiçbirinde p53 ile nükleer immünreaksiyon gözlenmemesi, p53'ün tiroid karsinogenezisinde daha ileri basamaklarda rol aldığı görüşünü desteklemektedir.


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Feb 13, 2015