Int J Thyroidol.  2017 Nov;10(2):96-101. 10.11106/ijt.2017.10.2.96.

Clinical Characteristics and Prognosis of Differentiated Thyroid Carcinoma with Small Foci of Anaplastic Transformation

• Ahn HY
• Jung KC
• Park DJ
• Park YJ
• Cho BY

• KMID: 2396813
• DOI: http://doi.org/10.11106/ijt.2017.10.2.96

Abstract

BACKGROUND AND OBJECTIVES
Anaplastic thyroid carcinoma (ATC) is commonly related with concurrent differentiated thyroid carcinoma (DTC). We aimed to examine the clinicopathologic characteristics, prognosis and gene expression of DTC with anaplastic foci.
MATERIALS AND METHODS
Eighteen patients with DTC with anaplastic foci were enrolled in this study. To compare the clinicopathologic characteristics and prognosis of anaplastic foci subjects with conventional ATC or DTC, we additionally included 12 ATC and 1030 DTC patients who diagnosed during same period. Immunohistochemistry was performed to check the gene expression in anaplastic foci and DTC component.
RESULTS
In anaplastic foci group, tumor size was larger (2.5±1.3 vs. 1.2±0.9 cm, p=0.001), distant metastasis was more frequent (11.1 vs. 0%, p=0.000) and 1-year survival rate was low (88.9 vs. 100%, p=0.000) than DTC group. In contrast, compared with ATC group, anaplastic foci group showed younger age at diagnosis (50±16 vs. 63±18 years, p=0.039), smaller tumor size (2.5±1.3 vs. 3.8±1.4 cm, p=0.027), less distant metastasis (11.1 vs. 41.7%, p=0.084) and longer 1-year survival rate (88.9 vs. 25.0%, p=0.001). Expression of p53 protein was observed in 100% of anaplastic foci, ATC and 12.5% of papillary thyroid carcinoma component.
CONCLUSION
DTC with foci of anaplastic transformation has a worse prognosis than DTC, but a better prognosis than ATC. Our results support that DTC with anaplastic foci was intermediate state from DTC to ATC.

Keyword

Thyroid carcinoma; Anaplastic; Thyroid neoplasm; Tumor suppressor protein p53; Prognosis

MeSH Terms

Diagnosis
Gene Expression
Humans
Immunohistochemistry
Neoplasm Metastasis
Prognosis*
Survival Rate
Thyroid Carcinoma, Anaplastic
Thyroid Gland*
Thyroid Neoplasms*
Tumor Suppressor Protein p53
Tumor Suppressor Protein p53

Figure

• 

  Fig. 1 The survival curve of those patients with anaplastic thyroid carcinoma (solid line), papillary thyroid carcinoma with anaplastic foci (dashed line) and papillary thyroid carcinoma (dotted line). p-value 0.000 by log rank test.

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