Role of P53, E-cadherin and BRAF as predictors of regional nodal recurrence for papillary thyroid cancer

• Published in: Annals of diagnostic pathology Vol. 40; pp. 59 - 65
• Main Authors: Ali, Khadiga M., Awny, Shadi, Ibrahim, Dina Abdallah, Metwally, Islam H., Hamdy, Omar, Refky, Basel, Abdallah, Ahmed, Abdelwahab, Khaled
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-06-2019
• Subjects: Antigens, CD - metabolism; BRAF; Cadherins - metabolism; E-cadherin; Female; Humans; Immunohistochemistry; Male; Middle Aged; Neoplasm Recurrence, Local; P53; Papillary thyroid cancer; Prognosis; Proto-Oncogene Proteins B-raf - metabolism; Regional nodal recurrence; Retrospective Studies; Thyroid Cancer, Papillary - diagnosis; Thyroid Cancer, Papillary - metabolism; Thyroid Cancer, Papillary - pathology; Thyroid Neoplasms - diagnosis; Thyroid Neoplasms - metabolism; Thyroid Neoplasms - pathology; Tumor Suppressor Protein p53 - metabolism; FV PTC; Regional nodal recurrence; Papillary thyroid cancer; PMC; RNR; BRAF; RAI; E-cadherin; PTC; P53
• ISSN: 1092-9134; 1532-8198
• DOI: 10.1016/j.anndiagpath.2019.04.005

Regional nodal recurrence (RNR) in patients diagnosed with papillary thyroid carcinoma (PTC) has increased. Variable immunohistochemical (IHC) markers have been studied for predicting the likelihood of PTC for recurrence. We aimed to clarify the IHC expression of p53, Ecadherin and BRAF as potential markers of RNR in PTC.
145 (73 study group and 72 control group) patients with PTC were analyzed retrospectively between January 2010 and June 2017. Further classification to a specific histological variant was done, and IHC expression of p53, Ecadherin and BRAF was analyzed both in the primary tumor and in nodal recurrence.
Regarding the risk of RNR, we found certain clinicopathologic features as elder age ≥55 years, tumor size >1 cm, presence of microscopic extrathyroid extension, presence of lymphovascular emboli, and conventional papillary subtype. Furthermore, IHC results for negative E-cadherin, and positive P53 and BRAF are significant risk factors, while radioactive iodine (RAI) adjuvant therapy decrease recurrence risk.
We found several risk factors for RNR in PTC diagnosed patients, all of which are easily achievable in clinical settings. In this regard, we suggested that patients with specific clinicopathologic and immunohistochemical features have strict follow up for early detection of RNR as it has a great impact on their survival.
•Regional nodal recurrence (RNR) can ocuur in patient with papillary thyroid cancer•Clinicopathologic factors associated with RNR are variable.•The triple print of P53 and BRAF positivity combined with E-cadherin negativity was significantly associated with RNR•The molecular verfication of the BRAF mutation is mandatory to support the utility of BRAF inhibitors, such as Vemurafenib.•Radioactive iodine (RAI) adjuvant therapy decrease recurrence risk.