Impact of Epithelial-Mesenchymal Immunophenotype on Local Aggressiveness in Papillary Thyroid Carcinoma Invading the Airway.

Martina Mandarano,Jacopo Vannucci,Andrea Polistena,Guido Bellezza,Efisio Puxeddu,Massimo Monacelli,Sonia Moretti,Marco Andolfi,Angelo Sidoni,Renato Colella,Francesco Puma,Alessandro Sanguinetti,Nicola Avenia

doi:10.3390/jcm10194351

Abstract

Primary thyroid tumours show different levels of aggressiveness, from indolent to rapidly growing infiltrating malignancies. The most effective therapeutic option is surgery when radical resection is feasible. Biomarkers of aggressiveness may help in scheduling extended resections such as airway infiltration, avoiding a non-radical approach. The aim of the study is to evaluate the prognostic role of E-cadherin, N-cadherin, Aryl hydrocarbon receptor (AhR), and CD147 in different biological behaviours. Fifty-five samples from three groups of thyroid carcinomas were stained: papillary thyroid carcinomas (PTCs) infiltrating the airway (PTC-A), papillary intra-thyroid carcinomas (PTC-B) and poorly differentiated or anaplastic thyroid carcinomas (PDTC/ATC). High expressions of N-cadherin and AhR were associated with higher locoregional tumour aggressiveness (p = 0.005 and p < 0.001 respectively); PDTC/ATC more frequently showed a high expression of CD147 (p = 0.011), and a trend of lower expression of E-cadherin was registered in more aggressive neoplasms. Moreover, high levels of AhR were found with recurrent/persistent diseases (p = 0.031), particularly when tumours showed a concomitant high N-cadherin expression (p = 0.043). The study suggests that knowing in advance onco-biological factors with a potential role to discriminate between different subsets of patients could help the decision-making process, providing a more solid therapeutic indication and an increased expectation for radical surgery.

Highlights

Thyroid cancer is the most common endocrine malignancy
A comparative retrospective observational study on the expression of E-cadherin, N-cadherin, Aryl hydrocarbon receptor (AhR) and CD147 was performed on a series of patients undergoing surgery
poorly differentiated thyroid carcinoma (PDTC) and ATC are more aggressive with a severe natural history

Summary

Introduction

Thyroid cancer is the most common endocrine malignancy. This disease varies from indolent tumour to highly aggressive disease [1]. Airway invasion is found in approximately 6% of the total thyroid tumours and can determine different clinical conditions. These patients can show normal breathing or severe obstruction in the most advanced disease progression [5,6]. In such conditions, the ideal surgical treatment is still a matter of debate. Concerning the airway invasion, the shaving-off of the tumour from the airway or tracheal window resection is performed in the case of superficial invasion, while segmental resection is preferred when the airway invasion is deeper in the laryngo-tracheal wall [4]

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