Elsevier

Surgery

Volume 156, Issue 6, December 2014, Pages 1550-1558
Surgery

American Association of Endocrine Surgeons
E-selectin expression and BRAF status in papillary thyroid carcinomas: Correlation with clinicopathologic features

https://doi.org/10.1016/j.surg.2014.08.049Get rights and content

Background

Cell adhesion molecules, represented by the immunoglobulin family and selectins, play an important role in the progression of cancer. A correlation between selectins and tumor aggressiveness has been demonstrated in several reports.

Methods

Eighty-eight patients (mean age, 41.0 ± 14 years) with papillary thyroid carcinoma (conventional variant and sized approximately 20 mm) were divided in 2 groups: 41 with encapsulated tumors and 47 with tumors with extrathyroidal extension. E-selectin expression was evaluated by immunohistochemical staining and semiquantitative real-time reverse-transcription polymerase chain reaction and normalized by calculating the z-score (positive: value above the population mean; negative: below the mean).

Results

Lymph node metastasis (LNM) was found in 2 of 41 encapsulated tumors (4.8%) and in 19 of 47 tumors (40.4%) with extrathyroidal extension. BRAF mutation was present in 21 encapsulated tumors (51.2%) and in 31 tumors with extrathyroidal extension (65.9%). The mean E-selectin z-score was −0.32 for encapsulated tumors and 0.28 for tumors with extrathyroidal extension. E-selectin expression correlates with neoplastic infiltration (P = .04), the American Joint Commission on Cancer stage (P = .02), and BRAF mutation (P = .03).

Conclusion

E-selectin overexpression in association with BRAF mutation status could promote a more aggressive phenotype in papillary thyroid carcinoma.

Section snippets

Methods

Formalin-fixed and paraffin-embedded (FFPE) thyroid specimens from 88 patients (20 male, 68 female) with a conventional variant of PTC who underwent operation at the Department of Surgical Pathology from January 2006 to December 2012 were retrospectively reviewed. Patients were a mean age of 41.0 ± 14 years (range, 12–78 years). The mean tumor size was 18.6 ± 1.4 mm (range, 15.0–20.0 mm). This study was approved by the Institutional Review Board, and informed consent was obtained from all

Results

We analyzed 88 tumors histologically diagnosed as conventional variant of PTC and whose size was <20 mm. According to the degree of neoplastic infiltration, 41 of the 88 tumors were totally encapsulated, and 47 had extrathyroidal invasion. Tumor multifocality was observed in 36 patients (41%). Lymph node metastases were identified in 21 patients (24%), 7 in whom they were only in the central compartment, and 14 in whom they also were in lateral compartment. Lymphocytic thyroiditis was observed

Discussion

The histologic demonstration of extrathyroidal extension has been described as having the “most significant bearing on prognosis” in patients with well-differentiated PTC.20 Moreover, oncologic outcome of patients with PTC correlates with the degree of extent of extrathyroidal invasion.3, 4 On one hand, outcome is worse in patients with gross extrathyroidal disease extension than in those with microscopic local invasion apparent on the histopathologic assessment.4 On the other hand, the

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