Abstract
ABSTRACT Downregulation of lncRNA H19 (H19) expression is associated with an unfavorable prognosis in some cancers. However, little was known as to whether there was an association between H19 and minimally invasive follicular thyroid carcinoma (MI-FTC). In our study, we used quantitative real-time polymerase chain reaction (qRT-PCR) to determine H19 expression in 186 patients with MI-FTC who underwent initial surgery. Of the 186 patients with MI-FTC, 21 patients show distant metastasis （M+）at the initial operation established the diagnosis of MI-FTC. Of the 165 patients who did not show distant metastasis at diagnosis during the follow-up period (≥10 years), 28 patients undergone M+ and 137 patients has no distant metastasis（M-）after the initial operation. Low H19 expression was associated with large tumor size, vascular invasion, and distant metastasis. Univariate analysis showed that gender (male), age (45 years or older), primary tumor size (4 cm or more), vascular invasion and H19 level (<1.12) were significant prognostic factors related to postoperative distant metastases. Multivariate analysis showed that age, primary tumor size (4 cm or more) and vascular invasion was a significant prognostic factor for survival. Patients with low H19 expression showed a poorer outcome in MI-FTC patients. Receiver-operating characteristic (ROC) curve analysis demonstrated H19 could distinguish M+ from M- patientswith a value of area under the curve (AUC). Our findings suggest that H19 is a potential prognostic factor for evaluating prognosis and the metastatic potential of MI-FTC at an initial operation stage.
Highlights
Follicular thyroid cancers (FTC) comprise between 10–15% of all differentiated thyroid cancers
We have recently found that expression of H19 was lower in the papillary thyroid carcinoma (PTC) tissues, and low expression of H19 was associated with extrathyroid extension, pathological lateral node metastasis, histological aggressive type and poorer disease-free survival
In the M (+) group, distant metastasis was diagnosed at the time of the initial surgery (n = 21) and after the initial operation established the diagnosis of minimally invasive FTC (MI-FTC) during the follow-up period (n = 28)
Summary
Follicular thyroid cancers (FTC) comprise between 10–15% of all differentiated thyroid cancers. According to the World Health Organization (WHO) classification of thyroid tumors, FTC is defined by the presence of capsular and/or vascular invasion and by the absence of nuclear features typical of papillary thyroid carcinoma (PTC) [1]. FTC is more likely to metastasize to distant organs rather than to regional lymph nodes because of its tendency to invade blood vessels resulting in hematogenous dissemination [2]. Like PTC, FTC retains many characteristics of thyroid follicular cells, including the expression of thyroid-specific proteins such as TSH receptor, thyroid peroxidase (TPO), and thyroglobulin (Tg) that serve as targets for thyroid autoimmunity. FTC is further divided into minimally invasive FTC (MI-FTC), which only has limited capsular and/or vascular invasion
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
