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Comparative histopathological analysis of sporadic pediatric papillary thyroid carcinoma from Japan and Ukraine
Tetiana I Bogdanova1,2, Vladimir A Saenko1, Mitsuyoshi Hirokawa3
1Atomic Bomb Disease Institute, Nagasaki University, Nagasaki 852-8523, Japan.
Insights
Japanese pediatric papillary thyroid carcinoma (PTC) shows more invasive features and oxyphilic cell metaplasia compared to Ukrainian PTC. These differences were observed in both childhood and adolescent age groups, highlighting geographical variations in tumor characteristics.
Area of Science:
- Endocrinology
- Pediatric Oncology
- Pathology
Background:
- Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy in children and adolescents.
- Geographical variations in iodine intake may influence the clinicopathological characteristics of PTC.
- Understanding these variations is crucial for accurate diagnosis and treatment strategies in pediatric populations.
Purpose of the Study:
- To compare the structural and invasive characteristics of sporadic PTC in Japanese and Ukrainian pediatric and adolescent patients.
- To provide a detailed histopathological analysis of PTC tumors from different geographical areas with varying iodine intake levels.
- To identify potential geographical disparities in PTC tumor behavior and presentation.
Main Methods:
- Analysis of 348 sporadic PTC cases from Japan (n=160) and Ukraine (n=188) in patients without a history of radiation exposure.
- Tumors were analyzed as a combined pediatric group and subdivided into childhood (≤14 years) and adolescent (15-18 years) age series.
- Multivariate comparison of histopathological features including growth patterns, cell types, tumor spread, and metastasis.
Main Results:
- Japanese pediatric PTC exhibited a higher sex ratio, increased frequency of microcarcinoma, papillary growth pattern, focal oxyphilic cell metaplasia, intrathyroid spread, lymphatic/vascular invasion, and regional lymph node metastases.
- Ukrainian PTC showed a higher prevalence of multifocal, non-encapsulated tumors with a solid-trabecular growth pattern.
- Significant differences in invasive properties, such as lymphatic/vascular invasion and nodal disease, were noted in childhood Japanese PTC compared to Ukrainian PTC. Adolescent Japanese PTC also showed more lymph node metastases and a higher frequency of the papillary growth pattern.
Conclusions:
- Japanese pediatric PTC demonstrates significantly higher frequencies of oxyphilic cell metaplasia and more pronounced invasive features compared to Ukrainian PTC.
- These findings highlight major geographical differences in the histopathological characteristics of pediatric and adolescent PTC between Japan and Ukraine.
- The study underscores the importance of considering geographical origin and iodine intake in the evaluation of pediatric PTC.
Abstract:
This study set out to compare structural and invasive characteristics of sporadic papillary thyroid carcinoma (PTC) in age-matched groups of children and adolescents of Japan and Ukraine to provide detailed histopathological analysis of tumors from different geographical areas with different iodine intake. A total of 348 (160 Japanese and 188 Ukrainian) PTCs from patients without radiation history were analyzed initially as a combined pediatric group and then subdivided into childhood (aged ≤14 years) and adolescent (aged from 15 to ≤18 years) age series. On multivariate comparison, the Japanese pediatric PTC was characterized by a higher sex ratio (p=1.504E-4), and a higher frequency of microcarcinoma (p=0.039), papillary dominant growth pattern (p=0.024), focal oxyphilic cell metaplasia (p=7.644E-6), intrathyroid spread (p=0.010), lymphatic/vascular invasion (p=0.01) and regional lymph node metastases (p=3.540E-6). In the Ukrainian group, multifocal (p=0.004) and non-encapsulated tumors with the solid-trabecular growth pattern (p=0.05) were more frequent. Childhood Japanese PTCs differed from Ukrainian PTCs by more pronounced invasive properties such as lymphatic/vascular invasion and nodal disease, but did not differ by the dominant growth pattern. In adolescents, the differences were detected not only for lymph node metastases, but also for a higher frequency of the papillary dominant pattern in Japanese PTC. Overall, significantly higher frequencies of oxyphilic cell metaplasia and more pronounced invasive features observed in the Japanese PTC in both age-matched series represent the major differences between the tumors from two geographical areas.
