Molecular Predictors for Advanced Papillary Thyroid Carcinoma Recurrence.

Area of Science:

• Oncology
• Molecular Pathology
• Endocrinology

Background:

• Papillary thyroid carcinoma (PTC) frequently recurs despite indolent behavior, impacting patient quality of life.
• Molecular predictors for PTC recurrence remain poorly defined, necessitating further investigation.
• Long-term prognostic markers in advanced PTC require evaluation for improved patient management.

Purpose of the Study:

• To assess the long-term prognostic value of aggressiveness markers in advanced PTC.
• To identify molecular predictors associated with recurrence and survival in PTC patients.
• To correlate immunohistochemical markers with clinical-pathological features and patient outcomes.

Main Methods:

• Immunohistochemistry was performed for BRAF^V600E, Estrogen receptor α, Progesterone receptor, Ki-67, and E-cadherin in 53 advanced PTC primary tumors.
• A long-term follow-up (10-20 years) cohort from Brazil was utilized for analysis.
• Statistical analyses included Chi-squared, Fisher's exact tests, logistic regression, Kaplan-Meier, Log-rank, and Peto tests.

Main Results:

• Persistence and recurrence were linked to age (≥55), tumor size (>2 cm), extrathyroidal extension, local aggressiveness, lymph node metastasis, and TNM stage.
• BRAF^V600E mutation correlated with extrathyroidal extension and local aggressiveness, inversely with distant metastasis.
• Progesterone receptor (PR) positivity was associated with active disease and shorter recurrence-free survival (p=0.001). Loss of E-cadherin expression increased the probability of active disease (OR=3.75).

Conclusions:

• BRAF^V600E may serve as a biomarker for local aggressiveness in advanced PTC.
• Progesterone receptor positivity and E-cadherin loss are potential predictors of recurrence in advanced PTC.
• Identifying these markers can aid in risk stratification and personalized treatment strategies for advanced PTC.