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Comparative Lesions Analysis Through a Targeted Sequencing Approach
Published on: November 5, 2019
Molecular analysis of multifocal papillary thyroid carcinoma
Xiaoqi Lin1, Sydney D Finkelstein, Bing Zhu
1Department of Pathology, Feinberg School of Medicine, Northwestern Memorial Hospital, Northwestern University, 251 East Huron Street, Feinberg Building 7-209C, Chicago, Illinois 60611, USA. xlin@northwestern.edu
Journal of Molecular Endocrinology
|July 17, 2008
Summary
Molecular analysis distinguishes independent primary from intrathyroid metastatic papillary thyroid carcinoma (PTC). This distinction is crucial for predicting lymph node metastasis and patient prognosis, even in papillary microcarcinoma.
Area of Science:
- Oncology
- Genetics
- Molecular Biology
Background:
- Papillary thyroid carcinoma (PTC) often presents as multifocal tumors.
- Differentiating independent primary (IP) PTC from intrathyroid metastatic (ITM) PTC is clinically significant.
Purpose of the Study:
- To investigate the utility of molecular markers in distinguishing multifocal IP from ITM papillary thyroid carcinoma.
- To assess the correlation between molecular profiles, lymph node metastasis, and tumor aggressiveness.
Main Methods:
- Analysis of 19 molecular markers, including loss of heterozygosity (LOH) and BRAF mutations, on 42 tumors from 18 multifocal PTC cases.
- Comparison of molecular profiles between separate tumors within multifocal PTC cases.
Main Results:
- In 66.7% of cases, tumors shared similar molecular profiles, indicating ITM. Different profiles in 33.3% of cases suggested IP.
- ITM, including papillary microcarcinoma, was associated with increased lymph node metastasis.
- Specific LOHs (17q21, 17p13, 10q23, 22q13) correlated with lymph node metastasis. Papillary microcarcinoma exhibited similar genomic mutations to conventional PTC, with larger PTCs showing higher mutation frequencies.
Conclusions:
- Molecular analysis effectively differentiates multifocal IP from ITM PTC.
- Molecular profiling is a valuable predictor of lymph node metastasis, aggressiveness, and prognosis, potentially more so than tumor size.
- Distinct molecular profiles across PTC variants may influence their clinical behavior.
