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Diffuse sclerosing variant of papillary thyroid carcinoma: major genetic alterations and prognostic implications.
Histopathology 2016; 69(1):45-53H

Abstract

AIM

Diffuse sclerosing variant of papillary thyroid carcinoma (DSV-PTC) is an uncommon variant of PTC, and its prognostic significance remains controversial. The aim of this study was to investigate the major genetic alterations of DSV-PTC and their prognostic implications.

METHODS AND RESULTS

We included 37 patients with DSV-PTC who underwent thyroid surgery and had formalin-fixed paraffin-embedded samples. We tested for a panel of genetic alterations, including BRAF(V) (600E) , NRAS codon 61, HRAS codon 12/13/61 and KRAS codon 12/13 point mutations as well as RET/PTC1, RET/PTC3 and PAX8/PPARγ rearrangements using reverse transcription real-time polymerase chain reaction (PCR). All genetic alterations found on PCR were confirmed by Sanger sequencing. Associations between the identified genetic alterations and clinicopathological characteristics were evaluated. Among 37 cases of DSV-PTC, 17 were positive for RET/PTC1 (46%), six for RET/PTC3 (16%) and nine for BRAF(V) (600E) (24%). All mutations/rearrangements were mutually exclusive. The remaining five cases had none of the above genetic alterations. DSV-PTC with RET/PTC3 rearrangement was associated with advanced-stage disease, including T4 and distant metastasis (P < 0.05). Patients with RET/PTC3 showed a higher frequency of persistent disease (P < 0.01). In contrast, DSV-PTC with RET/PTC1 was associated with a higher prevalence of disease remission (P < 0.05) and coexistent Hashimoto's thyroiditis (P < 0.01).

CONCLUSION

Taken together, RET/PTC rearrangement was the major genetic alteration seen in patients with DSV-PTC, and the RET/PTC3 rearrangement was associated with advanced stage at diagnosis and poor clinical outcome.

Authors+Show Affiliations

Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.BioSewoom Inc., Seoul, Korea.BioSewoom Inc., Seoul, Korea.Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26568156

Citation

Joung, Ji Y., et al. "Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma: Major Genetic Alterations and Prognostic Implications." Histopathology, vol. 69, no. 1, 2016, pp. 45-53.
Joung JY, Kim TH, Jeong DJ, et al. Diffuse sclerosing variant of papillary thyroid carcinoma: major genetic alterations and prognostic implications. Histopathology. 2016;69(1):45-53.
Joung, J. Y., Kim, T. H., Jeong, D. J., Park, S. M., Cho, Y. Y., Jang, H. W., ... Kim, S. W. (2016). Diffuse sclerosing variant of papillary thyroid carcinoma: major genetic alterations and prognostic implications. Histopathology, 69(1), pp. 45-53. doi:10.1111/his.12902.
Joung JY, et al. Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma: Major Genetic Alterations and Prognostic Implications. Histopathology. 2016;69(1):45-53. PubMed PMID: 26568156.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diffuse sclerosing variant of papillary thyroid carcinoma: major genetic alterations and prognostic implications. AU - Joung,Ji Y, AU - Kim,Tae H, AU - Jeong,Dae J, AU - Park,Sun-Mi, AU - Cho,Yoon Y, AU - Jang,Hye W, AU - Jung,Yoon Y, AU - Oh,Young L, AU - Yim,Hyun S, AU - Kim,Yoo-Li, AU - Chung,Jae H, AU - Ki,Chang-Seok, AU - Kim,Sun W, Y1 - 2016/01/11/ PY - 2015/09/17/received PY - 2015/11/07/accepted PY - 2015/11/17/entrez PY - 2015/11/17/pubmed PY - 2017/7/1/medline KW - BRAF KW - diffuse sclerosing variant KW - papillary thyroid carcinoma KW - ret-PTC fusion oncoproteins KW - thyroid cancer SP - 45 EP - 53 JF - Histopathology JO - Histopathology VL - 69 IS - 1 N2 - AIM: Diffuse sclerosing variant of papillary thyroid carcinoma (DSV-PTC) is an uncommon variant of PTC, and its prognostic significance remains controversial. The aim of this study was to investigate the major genetic alterations of DSV-PTC and their prognostic implications. METHODS AND RESULTS: We included 37 patients with DSV-PTC who underwent thyroid surgery and had formalin-fixed paraffin-embedded samples. We tested for a panel of genetic alterations, including BRAF(V) (600E) , NRAS codon 61, HRAS codon 12/13/61 and KRAS codon 12/13 point mutations as well as RET/PTC1, RET/PTC3 and PAX8/PPARγ rearrangements using reverse transcription real-time polymerase chain reaction (PCR). All genetic alterations found on PCR were confirmed by Sanger sequencing. Associations between the identified genetic alterations and clinicopathological characteristics were evaluated. Among 37 cases of DSV-PTC, 17 were positive for RET/PTC1 (46%), six for RET/PTC3 (16%) and nine for BRAF(V) (600E) (24%). All mutations/rearrangements were mutually exclusive. The remaining five cases had none of the above genetic alterations. DSV-PTC with RET/PTC3 rearrangement was associated with advanced-stage disease, including T4 and distant metastasis (P < 0.05). Patients with RET/PTC3 showed a higher frequency of persistent disease (P < 0.01). In contrast, DSV-PTC with RET/PTC1 was associated with a higher prevalence of disease remission (P < 0.05) and coexistent Hashimoto's thyroiditis (P < 0.01). CONCLUSION: Taken together, RET/PTC rearrangement was the major genetic alteration seen in patients with DSV-PTC, and the RET/PTC3 rearrangement was associated with advanced stage at diagnosis and poor clinical outcome. SN - 1365-2559 UR - https://www.unboundmedicine.com/medline/citation/26568156/Diffuse_sclerosing_variant_of_papillary_thyroid_carcinoma:_major_genetic_alterations_and_prognostic_implications_ L2 - https://doi.org/10.1111/his.12902 DB - PRIME DP - Unbound Medicine ER -