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Well-differentiated thyroid carcinomas: p53 mutation status and microvessel density
J D Goldenberg1, L G Portugal, B L Wenig
1Department of Otolaryngology-Head and Neck Surgery, Eye and Ear Infirmary, University of Illinois at Chicago, 60612, USA.
Head & Neck
|March 4, 1998
Summary
This study found that while microvessel density (MVD) increased in thyroid tumors, it did not predict clinical outcomes. P53 gene mutations also did not serve as a prognostic indicator for well-differentiated thyroid carcinoma.
Area of Science:
- Oncology
- Pathology
- Molecular Biology
Background:
- Established risk-stratification schemes for well-differentiated thyroid carcinoma exist, incorporating factors like age, sex, tumor extent, size, and metastasis.
- Clinical outcomes in low-risk patients have raised questions regarding the optimal aggressiveness of initial surgical intervention.
- The prognostic significance of biologic tumor markers, p53 gene mutation and CD34 microvessel density (MVD), requires further investigation in well-differentiated thyroid tumors.
Purpose of the Study:
- To determine the prognostic significance of p53 gene mutation and CD34 microvessel density (MVD) in well-differentiated thyroid carcinoma.
- To evaluate the correlation between these biologic markers and clinical behavior or pathological features.
- To assess their utility as independent prognosticators in thyroid cancer management.
Main Methods:
- Selection of 38 patients with well-differentiated thyroid carcinomas from the University of Illinois Tumor Registry.
- Average clinical follow-up of 10 years for all selected patients.
- Immunohistochemistry performed on paraffin-embedded tumor specimens to identify p53 gene mutations and quantify CD34 microvessel density (MVD).
Main Results:
- Microvessel density (MVD) counts were significantly increased in thyroid tumor tissue compared to surrounding normal tissue.
- No significant correlation was found between elevated MVD and tumor histology or recurrence rates.
- A trend suggested higher MVD counts in patients initially presenting with metastatic lymphadenopathy. P53 mutation expression was observed in 28% of cases, with no correlation to histology, sex, recurrence, or survival.
Conclusions:
- The study supports the concept of tumor neovascularization but did not establish a correlation between MVD and the clinical behavior or pathological features of well-differentiated thyroid carcinoma.
- P53 mutation status was found not to be an independent prognosticator of tumor behavior in the studied thyroid lesions.
- Further research may be needed to identify reliable prognostic markers for optimizing treatment strategies in well-differentiated thyroid carcinoma.