Endocrinology and Metabolism

Case Report

A Case of Polyglandular Autoimmune Syndrome.: In Pyo Jun, Suck Hwan Lim, Won Hyep Bae, Seung Jun Kim, Youn Ho Lee, Sun Ho Kim, Jung Kyu Lim, Jin Duk Hur; J Korean Endocr Soc. 1994;10(2):142-147. Published online November 6, 2019

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Abstract PDF: Polyglandular autoimmune(PGA) syndrome designates the dysfunction of endocrine and nonendocrine system involving two or more glands on the basis of autoimmunity. There are three types of PGA syndrome and their pathogenesis is still not completely understood. A 27-year-old woman developed polyglandular autoimmune syndrome manifesting insulin-dependent diabetes mellitus, myasthenia gravis and Graves' disease associated papillary thyroid carcinoma. The thyroid antimicrosomal antibody and antiacetylcholine receptor antibody were positive. Her HLA serotype was A2, A11, A62, B60, CW3, CW4, DR4, DR9.We report here a case of polyglandular autoimmune syndrome, type III manifesting insulin-dependent diabetes mellitus, myasthenia gravis and Graves' disease associated with papillary thyroid carcinoma.

Original Article

Predictive Factors for Incidental Contralateral Carcinoma in Patients with Unilateral Micropapillary Thyroid Carcinoma.: Jung Eun Huh, Sang Soo Kim, Ji Hyun Kang, Bo Gwang Choi, Byung Joo Lee, Jin Choon Lee, Yun Kyung Jeon, Bo Hyun Kim, Soo Geun Wang, Yong Ki Kim, In Joo Kim; Endocrinol Metab. 2012;27(3):194-199. Published online September 19, 2012; DOI: https://doi.org/10.3803/EnM.2012.27.3.194

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BACKGROUND
Whether thyroid lobectomy alone is a sufficient treatment for papillary thyroid microcarcinoma (PTMC) remains controversial. The aim of this study is to evaluate the predictive factors for incidental contralateral carcinoma in patients confirmed of unilateral PTMC preoperatively. METHODS: Between January 2007 and December 2009, 393 patients underwent thyroid surgery for unifocal and unilateral PTMC preoperatively at Pusan National University Hospital. A total thyroidectomy with central neck dissection was routinely performed for these patients during this study period. RESULTS: Among the 393 cases in the cohort, 77 patients (19.6%) had incidental PTMC in the contralateral lobe. In patients with incidental contralateral carcinoma, there was higher prevalence in extrathyroid extension, occult ipsilateral carcinoma, pathologic Hashimoto's thyroiditis, and central lymph node metastasis compared to those without contralateral carcinoma. The mean tumor size also increased in patients with contralateral carcinoma. Multivariate logistic regression showed that extrathyroid extension (P = 0.049), occult ipsilateral carcinoma (P < 0.001), pathologic Hashimoto's thyroiditis (P = 0.038), and central lymph node metastasis (P = 0.002) were predictive factors for incidental contralateral carcinoma. CONCLUSION: In conclusion, multifocality in the ipsilateral lobe, central lymph node metastasis, extrathyroid extension, and Hashimoto's thyroiditis is associated with the presence of contralateral carcinoma. Thus, if these factors are found by preoperative and/or postoperative evaluation, total thyroidectomy or completion thyroidectomy is necessary for the treatment of PTMC.

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Extent of surgery did not affect recurrence during 7‐years follow‐up in papillary thyroid cancer sized 1‐4 cm: Preliminary results
Min Joo Kim, Myung‐Chul Lee, Guk Haeng Lee, Hoon Sung Choi, Sun Wook Cho, Su‐jin Kim, Kyu Eun Lee, Young Joo Park, Do Joon Park
Clinical Endocrinology.2017; 87(1): 80. CrossRef

Case Reports

Four Cases of Malignant Pleural Effusion in Patients with Papillary Thyroid Carcinoma.: Min Ji Jeon, Ji Hye Yim, Eui Young Kim, Won Gu Kim, Tae Yong Kim, Won Bae Kim, Young Kee Shong; Endocrinol Metab. 2011;26(4):330-334. Published online December 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.4.330

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Papillary thyroid carcinoma could be a rare cause of malignant pleural effusion. The development of malignant pleural effusion in patients with papillary thyroid cancer is an extremely adverse prognostic indicator. Here, we report four cases that showed development of malignant pleural effusion during the clinical course of the papillary thyroid carcinoma and consider the prognosis. In four patients, the median survival time after the development of malignant pleural effusion was only 17 months.

Citations

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Pleural fluid due to papillary thyroid cancer
Tomohiro Tamura, Toshihiro Shiozawa, Hiroaki Satoh, Koichi Kurishima, Katsunori Kagohashi, Norio Takayashiki, Nobuyuki Hizawa
Oncology Letters.2019;[Epub] CrossRef
Outcome and characteristics of patients with malignant pleural effusion from differentiated thyroid carcinoma
Chisato Tomoda, Yuna Ogimi, Fumi Saito, Chie Masaki, Junko Akaishi, Kenichi Matsuzu, Akifumi Suzuki, Takashi Uruno, Keiko Ohkuwa, Hiroshi Shibuya, Wataru Kitagawa, Mitsuji Nagahama, Kiminori Sugino, Koichi Ito
Endocrine Journal.2016; 63(3): 257. CrossRef
A distinctive colour associated with high iodine content in malignant pleural effusion from metastatic papillary thyroid cancer: a case report
Andrew Rosenstengel, Ee Mun Lim, Michael Millward, YC Gary Lee
Journal of Medical Case Reports.2013;[Epub] CrossRef

A Case of Subacute Thyroiditis Associated with Papillary Thyroid Carcinoma and Takayasu's Arteritis.: Dongwon Yi, Seung Hoon Baek, Seok Man Son, Yang Ho Kang; Endocrinol Metab. 2011;26(4):324-329. Published online December 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.4.324

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Abstract PDF: Subacute thyroiditis is a self-limiting inflammation of the thyroid, presenting with painful thyroid swelling, thyrotoxicosis and low radioactive iodine uptake. The characteristic US findings for this disease are focal ill-defined hypoechoic areas in one lobe or diffuse hypoechoic areas in both lobes. Thyroid carcinomas should be included in the differential diagnosis for a lesion with focal hypoechoic areas and have been rarely reported to coexist with subacute thyroiditis. Takayasu's arteritis is an autoimmune disease that affects the aorta and its branches as well as pulmonary arteries. Subacute thyroiditis associated with Takayasu's arteritis is extremely rare, with only three cases being reported. We report here on the first case with the simultaneous diagnosis of subacute thyroiditis, papillary thyroid carcinoma and Takayasu's arteritis.

Original Articles

Association between Serum Thyroid Stimulating Hormone Level and Papillary Thyroid Microcarcinoma in Korean Euthyroid Patients.: Hyun Sook Kim, Seung Joon Lee, Jung Kyu Park, Chang Ho Jo, Ho Sang Shon, Eui Dal Jung; Endocrinol Metab. 2011;26(4):297-302. Published online December 1, 2011; DOI: https://doi.org/10.3803/EnM.2011.26.4.297

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BACKGROUND
Thyroid cancer is a common disease and its prevalence is increasing. Recent reports have shown that an elevated thyrotropin (thyroid stimulating hormone, TSH) level is associated with thyroid cancer risk. However, the association between TSH level and thyroid cancer risk is not yet known for euthyroid patients diagnosed with papillary thyroid microcarcinoma (PTMC). METHODS: Our study included 425 patients who underwent thyroid surgery and were diagnosed with PTMC between 2008 and 2009. Control group patients were diagnosed with benign nodules < or = 1 cm in size by US-guided fine needle aspiration. Nodules with one or more suspected malignant-ultrasonographic feature(s) were excluded from this study. Patients who were not euthyroid or who took thyroid medication were also excluded. RESULTS: The mean age of all patients was 48.5 +/- 11.0 years and 88.8% were women. The mean age of those with PTMC was significantly lower than that of the control group. The mean TSH level was 1.78 +/- 0.93 mIU/L, and the mean free T4 level was 15.96 +/- 2.32 pmol/L. There was no difference in TSH level between the PTMC and control groups (1.77 +/- 0.93 mIU/L vs. 1.79 +/- 0.91 mIU/L, P = 0.829). After adjusting for age, TSH level was not correlated with tumor size (r = 0.02, P = 0.678) in the PTMC group. Moreover, the TSH level did not differ between patients with stage I and stage III-IV carcinoma (stage I, 1.77 +/- 0.95 mIU/L; stage III-IV, 1.79 +/- 0.87 mIU/L; P = 0.856). CONCLUSION: TSH levels are not elevated in euthyroid PTMC patients. Thus, further evaluation is needed before serum TSH can be used as a tumor marker for small nodules < or = 1 cm in size in euthyroid patients.

Citations

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Evaluation of serum thyroid‐stimulating hormone as indicator for fine‐needle aspiration in patients with thyroid nodules
Ji Soo Choi, Chung Mo Nam, Eun‐Kyung Kim, Hee Jung Moon, Kyung Hwa Han, Jin Young Kwak
Head & Neck.2015; 37(4): 498. CrossRef

The Clinical Importance of Minimal Extrathyroid Extension on Tumor Recurrence in Patients with Papillary Thyroid Carcinoma.: Jung Min Kim, Yun Yong Lee, Chang Woon Choi, Sang Moo Lim, Seung Sook Lee, Soo Youn Cho, Guk Haeng Lee, Byeong Cheol Lee, Ka Hee Yi; Endocrinol Metab. 2010;25(4):340-346. Published online December 1, 2010; DOI: https://doi.org/10.3803/EnM.2010.25.4.340

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BACKGROUND
We wanted to evaluate whether a minimal extrathyroid extension (METE) is associated with the clinicopathological parameters that are indicative of a poor prognosis, including lymph node metastasis, distant metastasis at the time of the initial diagnosis and tumor recurrence, in patients with papillary thyroid carcinoma (PTC), and especially in the patients with papillary thyroid microcarcinoma (PTMC). METHODS: We retrospectively evaluated the medical records of patients with PTC and who had undergone total thyroidectomy with/without subsequent 131I remnant ablation at the Korea Cancer Center Hospital from January 1998 through December 2005. A total of 557 patients with PTC were enrolled in the study. We excluded 13 patients with an unknown status of extension and 29 patients with massive ETE. RESULTS: Of the 515 patients, 401 were found to have a METE. We analyzed the 464 patients who were without distant metastasis at the time of the initial diagnosis and who had a follow-up duration of more than 6 months. METE was not significantly associated with tumor recurrence during the follow-up period (median follow-up period: 122 months, range: 6-142 months): 8% vs. 15% of the patients with and without METE had tumor recurrence, respectively (P = 0.069 by the log-rank test). We analyzed the effect of tumor size in the patients with METE. Size was not significantly associated with tumor recurrence (P = 0.374 by the log-rank test). CONCLUSION: These findings suggest that METE might not be a prognostic factor to predict tumor recurrence in patients with PTC, including PTMC.

Citations

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Sonographic Assessment of the Extent of Extrathyroidal Extension in Thyroid Cancer
Sae Rom Chung, Jung Hwan Baek, Young Jun Choi, Tae-Yon Sung, Dong Eun Song, Tae Yong Kim, Jeong Hyun Lee
Korean Journal of Radiology.2020; 21(10): 1187. CrossRef
Papillary thyroid microcarcinoma: the significance of high risk features
Nori L. Bradley, Sam M. Wiseman
BMC Cancer.2017;[Epub] CrossRef
Clinical and Pathologic Predictors of Lymph Node Metastasis and Recurrence in Papillary Thyroid Microcarcinoma
Saaduddin Siddiqui, Michael G. White, Tatjana Antic, Raymon H. Grogan, Peter Angelos, Edwin L. Kaplan, Nicole A. Cipriani
Thyroid.2016; 26(6): 807. CrossRef
High metabolic tumor volume and total lesion glycolysis are associated with lateral lymph node metastasis in patients with incidentally detected thyroid carcinoma
Bo Hyun Kim, Seong-Jang Kim, Keunyoung Kim, Heeyoung Kim, So Jung Kim, Won Jin Kim, Yun Kyung Jeon, Sang Soo Kim, Yong Ki Kim, In Joo Kim
Annals of Nuclear Medicine.2015; 29(8): 721. CrossRef

Case Report

A Case of Coexistence of Parathyroid and Papillary Thyroid Carcinoma.: Yoon Shick Yom, Myung Jun Lee, Hyun Woo Lim, Jeong Ho Park, Sung Tae Kim, Yu Mi Lee, Dong Ju Yang, Youn Zoo Cho, Moon Il Park, Kang Woo Lee, Keun Young Park, Dong Mee Lim, Byung Joon Kim; J Korean Endocr Soc. 2010;25(1):61-67. Published online March 1, 2010; DOI: https://doi.org/10.3803/jkes.2010.25.1.61

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Abstract PDF: Primary hyperparathyroidism is usually caused by a parathyroid adenoma, occasionally by primary parathyroid hyperplasia and rarely by parathyroid carcinoma. Coincidental occurrence of thyroid carcinoma in parathyroid adenoma is not uncommon, but synchronous parathyroid and thyroid carcinoma is extremely rare. Here, we describe a case of synchronous parathyroid carcinoma and papillary thyroid carcinoma.

Original Articles

Clinico-pathologic Characteristics of the Primary Thyroid Cancer in Patients with Breast Cancer.: Hyun Won Shin, Hye Won Jang, Ji Young Park, Jae Hoon Chung, Young Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim, Sun Wook Kim; J Korean Endocr Soc. 2009;24(4):240-246. Published online December 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.4.240

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BACKGROUND
Both thyroid and breast cancers occur more frequently in women than in men. Some suggest that estrogen plays a role in the tumorigenesis of both cancers. The aim of this study was to identify the prevalence and clinico-pathologic characteristics of primary thyroid cancer in patients with breast cancer. METHODS: We retrospectively obtained clinical and pathologic data for 112 patients diagnosed with both thyroid and breast cancer from a single center. Patients with thyroid cancer were grouped according to the chronological sequence of tumor diagnosis. When thyroid and breast cancers were diagnosed within 12 months of each other, they were considered to have been diagnosed simultaneously. Female patients who had only papillary thyroid cancer were used as a historic control. RESULTS: Between 1994 and 2008, 7,827 patients at our hospital were diagnosed with breast cancer and 6,571 patients with thyroid cancer. There were 112 patients who had both thyroid and breast cancer. All thyroid cancers (111/112) except one hurthle cell cancer were papillary thyroid cancers. Average tumor size of thyroid cancer cases diagnosed 1) after or 2) simultaneously with the diagnosis of breast cancer was significantly lower than that for 3) thyroid cancer cases found before breast cancer diagnosis or 4) historical controls with papillary thyroid cancer [sizes (in cm), respectively, were: 1) 0.9 +/- 0.6 2) 0.9 +/- 0.5 vs 3) 1.4 +/- 0.9 4) 1.4 +/- 1.1, P < 0.05]. No patients had distant metastases and there were no statistically significant differences in known risk factors for recurrence and survival of patients with thyroid cancer. CONCLUSION: Thyroid cancer is the most common second primary malignancy in patients with breast cancer and most of them are papillary thyroid cancers. There are no differences in risk factors for tumor recurrence and patient survival compared with those with conventional papillary thyroid cancer except for differences in tumor size. These difference in size may reflect an increase in medical surveillance in patients after they are diagnosed with breast cancer.

Citations

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Survival Outcomes in Thyroid Cancer Patients with Co-Occurring Breast Cancer: Evidence of Mortality Risk Attenuation
Matheus Wohlfahrt Baumgarten, Iuri Martin Goemann, Rafael Selbach Scheffel, Ana Luiza Maia
Clinical Breast Cancer.2024; 24(6): e519. CrossRef
The prognosis and treatment of primary thyroid cancer occurred in breast cancer patients: comparison with ordinary thyroid cancer
Chang Min Park, Young Don Lee, Eun Mee Oh, Kwan-Il Kim, Heung Kyu Park, Kwang-Pil Ko, Yoo Seung Chung
Annals of Surgical Treatment and Research.2014; 86(4): 169. CrossRef
Thyroid Metastasis from Breast Carcinoma Accompanied by Papillary Thyroid Carcinoma
Song-I Yang, Kwang-Kuk Park, Jeong-Hoon Kim
Case Reports in Oncology.2014; 7(2): 528. CrossRef

Clinical Differences between Classic Papillary Thyroid Carcinoma and Variants.: Ji Young Park, Ji In Lee, Alice Hyun Kyung Tan, Hye Won Jang, Hyun Won Shin, Young Lyun Oh, Jung Hee Shin, Jung Han Kim, Ji Soo Kim, Young Ik Son, Sun Wook Kim, Jae Hoon Chung; J Korean Endocr Soc. 2009;24(3):165-173. Published online September 1, 2009; DOI: https://doi.org/10.3803/jkes.2009.24.3.165

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BACKGROUND
The outcomes of papillary thyroid carcinoma (PTC) variants have been described in a limited number of studies. The purpose of this study was to compare patient outcomes of PTC variants with those of patients with classic PTC. METHODS: A single-institution retrospective analysis was performed to review 2,366 patients with classic PTC and 159 patients with PTC variants diagnosed between 1994 and 2004. PTC variant patients were divided into two groups, favorable (n = 119, 119 follicular variants including 14 encapsulated follicular variants) and aggressive (n = 40, including 13 diffuse sclerosing, 11 tall cell, six solid, six oncocytic, and four columnar cell variants). RESULTS: Compared with classic PTC, the favorable and aggressive variants had a significantly larger tumor size (P<0.001). The favorable variants had significantly lower rates of bilaterality, multifocality, extrathyroidal invasion, cervical lymph node metastasis, stage III and IV disease, and greater male to female ratio (P<0.05). In particular, the encapsulated follicular variant showed no bilaterality, multifocality, extrathyroidal invasion, lymph node metastasis, and distant metastasis. However, the disease-specific survival and recurrence-free survival of patients with favorable PTC were not different from the patients with classic PTC. The aggressive variants had significantly higher rates of bilaterality and cervical lymph node metastasis compared to the classic PTC (P<0.05). They had significantly reduced disease-specific survival and recurrence-free survival rates (P<0.01). CONCLUSIONS: Knowledge of the nature of PTC variants, especially aggressive types, is important in predicting patient outcome and providing appropriate treatment. Further study is needed to better understand PTC variants.

Citations

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Ultrasonographic Characteristics of the Follicular Variant Papillary Thyroid Cancer According to the Tumor Size
Eon Ju Jeon, Young Ju Jeong, Sung Hwan Park, Chang Ho Cho, Ho Sang Shon, Eui Dal Jung
Journal of Korean Medical Science.2016; 31(3): 397. CrossRef
Follicular Variant of Papillary Thyroid Carcinoma: Distinct Biologic Behavior Based on Ultrasonographic Features
Sun Jung Rhee, Soo Yeon Hahn, Eun Sook Ko, Jae Wook Ryu, Eun Young Ko, Jung Hee Shin
Thyroid.2014; 24(4): 683. CrossRef

Case Report

Two Cases of the Diffuse Sclerosing Variant of Papillary Thyroid Carcinoma.: Hee Kwan Won, Myoung Jun Lee, Joo Ho Park, In Girl Song, Go Eun Lee, Ji Hyun Jeong, Jee Young Cheon, Hae Joung Sul, Dong Mi Lim, Keun Young Park; J Korean Endocr Soc. 2008;23(6):430-437. Published online December 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.6.430

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Abstract PDF: The diffuse sclerosing variant of papillary thyroid carcinoma (DSPTC) is a rare histological subtype characterized by diffuse involvement of one or both thyroid lobes, widespread lymphatic permeation, prominent fibrosis, squamous metaplasia, abundant psammoma body and lymphatic infiltration. This subtype usually occurs in young female, and exhibits a higher frequency of cervical and distant metastasis. DSPTC clinically resembles Hashimoto's thyroiditis, and often delays the correct diagnosis. We experienced two patients with DSPTC: the one patient presented with a neck mass lasting for a month, and in the other patient, a thyroid lesion was incidentally found during a medical examination.

Original Articles

Correlation between S100A4 and COX2 Overexpression and Invasiveness of Papillary Thyroid Carcinoma.: Kyungji Lee, Youn Soo Lee, Kyo Young Lee, Woo Chan Park, Young Sil Kim; J Korean Endocr Soc. 2008;23(3):186-192. Published online June 1, 2008; DOI: https://doi.org/10.3803/jkes.2008.23.3.186

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Abstract PDF: PURPOSE: Tumor cell invasion is characteristic of malignant neoplasms. S100A4, a member of a family of small calcium binding proteins, and COX2, seem to have a role in promoting progression and invasion of many human cancers. The clinical stage of a papillary thyroid carcinoma (PTC) depends on age, tumor size, and extrathyroidal extension. Extrathyroidal extension is correlated with the invasiveness of a tumor. However, there are no reliable prediction markers for invasiveness. We evaluated S100A4 and COX2 expression in PTCs to determine if expression correlates with invasiveness, and if expression of S100A4 and COX2 are useful as prediction markers. METHODS: The expression of S100A4 and COX2 were evaluated using immunohistochemical analysis in 35 PTC specimens. RESULTS: More intense staining in cells that invaded the front portion rather than the central portion of a PTC was indicative of increased expression of S100A4 and COX2. Therefore, cases were analyzed for extent of staining in tumor cells that invaded the front portion of a PTC. High expression group (higher expression than average expression rate) of S100A4 and COX2 were significantly correlated with extrathyroidal extension (P = 0.0094 and P = 0.0433, respectively). However, no other clinicopathological factors including age, lymph node involvement, and multiplicity were related to expression of S100A4 and COX2, as determined in this study. CONCLUSION: Extrathyroidal extension of a PTC had an unfavorable effect on prognosis. S100A4 and COX2 expression were associated with extrathyroidal extension. These findings suggest that expression of S100A4 and COX2 could be prognostic markers for PTC.

The Clinical Significance of Retinoic Acid Receptor beta Expressions in Primary and Recurred Metastatic Lymph Node Papillary Thyroid Carcinomas.: Jae Pil Han, Seong Jin Lee, Kyung Chan Choi, Young Euy Park, Hae Ri Lee, Jun Goo Kang, Ohk Hyun Ryu, Chul Sik Kim, Byung Wan Lee, Eun Gyung Hong, Hyeon Kyu Kim, Doo Man Kim, Jae Myung Yoo, Sung Hee Ihm, Hyung Joon Yoo, Moon Gi Choi; J Korean Endocr Soc. 2007;22(6):419-427. Published online December 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.6.419

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Abstract PDF: BACKGROUND
The present study was designed to investigate the correlations of retinoic acid receptor beta(RARbeta) expression for primary and recurred metastatic lymph node (LN) papillary thyroid carcinoma (PTC) tissues and the correlations of RARbeta expression with the uptake of I(131) as detected on a whole body scan (WBS). METHODS: Primary and metastatic LN PTC tissues were examined by immunohistochemical methods. Staining positivity was calculated, and staining intensity was graded as negative (0), weak (1+), moderate (2+) and strong (3+). Nuclear staining intensity (NSI) of cells from tissues was also examined. RESULTS: Seventeen patients who had regional cervical LN metastasis without distant metastasis were included in the study, and 13 patients had the abnormal uptake of I(131) as detected on a WBS. In primary PTC tissues, RARbeta staining positivity and intensity of carcinoma cells were significantly higher than those of normal cells but NSI was significantly higher in normal cells than carcinoma cells. Between primary and metastatic LN PTC tissues, RARbeta staining intensity was correlated after controlling for age. Primary PTC tissues from 14 (82.4%) out of 17 patients were concordant between NSI and the uptake of I(131) as detected on a WBS. NSI predicted the I(131) uptake as detected on a WBS with 81.3% positive predicted value (PPV) and 100% negative predicted value. Metastatic LN PTC tissues from 13 (76.5%) out of 17 patients were concordant between NSI and the uptake of I(131) as detected on a WBS. NSI predicted the uptake of I(131) as detected on a WBS with 76.5% PPV. When the results of NSI taken either as positive or negative were correlated with those of the uptake of I(131) as detected on a WBS in primary and metastatic LN PTC tissues, the correlation was not significant after controlling for age. CONCLUSION: Our results demonstrate that nuclear RARbeta expression may be decreased in PTC tissues than normal thyroid tissues, and RARbeta expression in primary PTC tissues as well as in recurred metastatic LN PTC tissues may predict the uptake of I(131) as detected on a WBS.

ras Mutation in Korean Papillary Thyroid Carcinomas.: Jung Hwa Jung, Keun Sook Kim, Tae Sik Jung, Young Lyun Oh, Hye Won Jang, Hye Seung Jung, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim, Jae Hoon Chung; J Korean Endocr Soc. 2007;22(3):203-209. Published online June 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.3.203

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Abstract PDF: BACKGROUND
RET/PTC rearrangement and mutations of BRAF and ras are well-known oncogenes involved in the pathogenesis of papillary thyroid carcinoma (PTC). The prevalence of RET/PTC rearrangement and BRAF mutations were 0~13% and 66~83% in Korean patients with PTC, respectively. We evaluated the prevalence of ras mutations in surgical specimens of PTC, and we compared them with the patients' clinical features. SUBJECTS AND METHODS: We included the surgical specimens of 49 PTCs and a few follicular thyroid carcinomas (FTCs) and follicular adenomas (FAs) as positive controls. Polymerase chain reaction, single strand conformation polymorphism and direct sequence analysis were consecutively performed to detect ras mutations. RESULTS: No mutations of the ras oncogenes were detected in 49 PTCs. However, heterozygous mutations of the ras oncogenes were found in a FTC and FA as positive controls, respectively. CONCLUSION: These findings suggested that ras mutation is not or rarely related to the tumorigenesis of PTCs in Koreans. Therefore, BRAF mutations and RET/PTC rearrangement, rather than ras mutation, might contribute the development of PTC in Koreans.

p53, p21 and bcl-2 Protein Expressions and the Clinical Significance in Papillary Thyroid Carcinoma.: Tae Sik Jung, Keun Sook Kim, Young Lyun Oh, Jung Hwa Jung, Eun Young Lee, Hye Seung Jung, Yong Ki Min, Myung Shik Lee, Moon Kyu Lee, Kwang Won Kim, Jae Hoon Chung; J Korean Endocr Soc. 2007;22(2):98-104. Published online April 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.2.98

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BACKGROUND
There have been some investigations concerning the role of p53, p21 and bcl-2 protein expressions for the tumorigenesis of thyroid cancer. It had been debated that these protein expressions were associated with aggressive features of papillary thyroid carcinoma. We studied to evaluate the prevalence of these protein expressions and their clinical significances in papillary thyroid carcinoma. METHODS: We selected 49 patients with papillary thyroid carcinoma who had been operated on at Samsung Medical Center during the last 10 years. Immunohistochemical staining for p53, p21 and bcl-2 was done by the use of paraffin embedded tissues. We analyzed the results of immunohistochemical staining for p53, p21 and bcl-2 and the correlation with the patients' age, gender, tumor size, multifocality, tumor invasion to both lobes, extrathyroidal invasion, cervical lymph node invasion, distant metastasis and the clinical outcomes. RESULTS: Immunohistochemical staining for p53 was positive in 10 patients (20%), p21 was positive in 36 patients (73%) and bcl-2 was positive in 18 patients (37%). The p53 and bcl-2 expressions were not associated with the clinical parameters. Tumor multifocality and extrathyroidal invasion were significantly higher in the p21 positive group (both P < 0.05). CONCLUSION: This study showed that the p21 protein expression was associated with tumor multifocality and extrathyroidal invasion in the patients with papillary thyroid carcinoma. Immunohistochemical stains for p21 may be used as a parameter for tumor aggressiveness in papillary thyroid carcinoma.

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Clinicopathologic and Diagnostic Significance of p53 Protein Expression in Papillary Thyroid Carcinoma
Mi Kyung Shin, Jeong Won Kim
Asian Pacific Journal of Cancer Prevention.2014; 15(5): 2341. CrossRef

The Relationship between the Expression of MHC Class II Antigens and the Clinical Prognosis of Papillary Thyroid Carcinoma Patients.: Jun Chul Lee, Seul Young Kim, Yun Sun Choi, Youn Sun Bai, Yun Jeung Kim, Ihn Suk Lee, Ki Hyun Kwon, So Young Rha, Bon Jeong Ku, Young Kun Kim, Heung Kyu Ro, Shengjin Li, Jin Man Kim, Young Suk Jo, Minho Shong; J Korean Endocr Soc. 2007;22(1):26-34. Published online February 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.1.26

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Abstract PDF: BACKGROUND
Papillary thyroid carcinoma is among the most curable cancers, but some patients are at high risk for recurrence or even death. MHC antigens are essential molecules for the pathogenesis of carcinoma and also the physiologic immune responses against tumor. However, there is no data about the relationship between the expression of MHC antigens and the clinical prognosis of papillary thyroid carcinoma patients. METHODS: We analyzed the relationship between the various prognostic factors and the MHC antigen expression by conducting a retrospective study of 215 patients, who had undergone thyroidectomy for papillary thyroid carcinoma between 1987 and 2003. RESULTS: The expressions of MHC class II antigens were more frequent in papillary thyroid carcinoma than in the other thyroid diseases. Yet there was no statistically significant relationship between most of the clinicopathological factors and the expression of MHC class II antigens in papillary thyroid carcinoma patients. Interestingly, an HLA-DR expression was found in 8 (30.8%) of the 26 patients in the recurrence group and in 13 (76.5%) of the 17 patients in the non-recurrence group, and HLA-DP/DQ immunoreactivity was positive in 10 (38.5%) cases of the recurrence group and in 14 (82.4%) cases of the non-recurrence group. CONCLUSION: Papillary thyroid carcinoma showed a more frequent expression of MHC Class II antigens. However, the recurred papillary thyroid carcinoma showed a tendency to downregulate the expression of MHC class II antigens. Hence, the molecular mechanism for the expression of MHC class II antigens might have a role in the recurrence of papillary thyroid carcinoma.

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