Adriana Handra-Luca
Abstract
Squamous cell differentiation (SCD) may occur in papillary thyroid carcinoma (PTC) only at metastatic sites. We have studied cytokeratin CK5/6 and P63 along with TTF1 (thyroid transcription factor 1) and B-Raf (V-Raf murine sarcoma viral oncogene homolog B1) immunohistochemical expression in neck ...
Read More
Squamous cell differentiation (SCD) may occur in papillary thyroid carcinoma (PTC) only at metastatic sites. We have studied cytokeratin CK5/6 and P63 along with TTF1 (thyroid transcription factor 1) and B-Raf (V-Raf murine sarcoma viral oncogene homolog B1) immunohistochemical expression in neck lymph node metastases of thyroid PTC showing SCD. The patient (21-years) presented with a neck mass. The check-up revealed bilateral thyroid nodules. Total thyroidectomy and neck lymph node dissection were performed. The diagnosis was that of bilateral PTC with lymph node metastases (pT1N1Mx). The metastases were peculiar by the presence of cystic change and of SCD. The thyroid PTC expressed P63 focally and, TTF1 and B-Raf diffusely. Cytokeratin 5/6 was expressed only in the lymph node metastases, in the metastatic cyst lining and in the SCD foci. The P63+ cells outnumbered those CK5/6+. TTF1 expression was faint in SCD. Metastatic, both classical PTC- and SCD-epithelia expressed B-Raf. The expression patterns of CK5/6, P63, TTF1 suggest a luminal/central-to-abluminal/peripheral direction for SCD development from PTC-epithelia in lymph node metastases. Whether this metaplasia type may reflect a regression to a less aggressive morphotype or a progression-switch to squamous cell carcinoma-type differentiation in a composite tumor remains matter of debate.
Ali Zare Mirzaei; Fatemeh Abdorrazaghi; Maryam Lotfi; Behrang Kazemi Nejad; Nasrin Shayanfar
Abstract
Background & Objectives: Colon cancer is currently of high incidence and mortality rate. Identifying the factors influencing its prognosis can be very beneficial to its clinical treatment. Recent studies have shown that lymph nodes ratio can be considered as an important prognostic factor. The aim ...
Read More
Background & Objectives: Colon cancer is currently of high incidence and mortality rate. Identifying the factors influencing its prognosis can be very beneficial to its clinical treatment. Recent studies have shown that lymph nodes ratio can be considered as an important prognostic factor. The aim of the present study is to investigate the effect of this factor on the prognosis of the patients presenting with stage III colon cancer and to compare the result with the effect of lymph node stage on their prognosis. Methods: This cross-sectional study was carried out on 66 patients of stage III colon cancer, who met the study inclusion criteria. Patients were categorized into four groups based on Kaplan-Meier plots: LNR1 0-12%, LNR2 13-40%, LNR3 41-84% and LNR4 85-100%. Survival was estimated by Kaplan-Meier method, and differences analyzed by Log-rank test. A Cox proportional hazards model was used for multivariate analysis. Results: Lymph nodes ratio was a significantly variable both in overall survival (P<0.0001) and in disease-free survival (P=0.009). Lymph node stage was significant in overall survival (P=0.008) but not in disease-free survival (P=0.05). Multivariable analysis of overall survival showed lymph nodes ratio as the only independent prognostic factor. Conclusion: Lymph node ratio is a more accurate prognostic factor than lymph node stage in overall survival and, in particular, in disease-free survival in patients with stage III colon cancer.
