CD15 (LeuM1) immunoreactivity: Prognostic factor for sporadic and hereditary medullary thyroid cancer?

Abstract

Patients treated for sporadic and hereditary medullary thyroid carcinoma (MTC) have varying rates of persistent disease, recurrence, and survival. The aim of this study was to correlate the immunoreactivity of the monoclonal antibody CD15 (LeuM1) to initial clinical findings and the outcome of treatment. The primary tumors of 75 patients with sporadic MTC, 7 with hereditary disease, and 3 members of MEN 2A families were studied. Of these subjects 74 (87%) showed no or little immunoreactivity (< 15% positive cells; score 0) in most tumors. The remaining 13% had surgery for tumors with more than 15% cells with positive staining (score I). There was no correlation between LeuM1 immunoreactivity and sex, age, and type of MTC. There was, however, a significant correlation with the pTNM classification and UICC staging. The prognosis for patients with score 0 was significantly better than score 1 patients. CD15 immunoreactivity appears to be a predictive factor in sporadic and hereditary MTC. Lymph node dissection seems to be more successful in patients with score 0 tumors than in those with score 1 tumors. The question of reoperation in patients with recurrence of disease (especially with biochemical recurrence or persistence) should be discussed on the basis of CD15 immunoreactivity.

Routine Measurement of Plasma Calcitonin in Nodular Thyroid Diseases

“…If so, the currently accepted data for the life expectancy of MTC may eventually prove to be inaccurate. However, as long as this point remains to be clarified there is no other choice but to proceed on the basis of currently available figures, which clearly call for early surgical ingression (16). Preoperative establishment of the diagnosis helps to plan the extent of surgery and facilitates the diagnosis of related endocrine disorders, such as primary hyperparathyroidism and pheochromocytoma.…”

Repeat mediastinal lymph-node dissection for palliation in advanced medullary thyroid carcinoma

“…Extrathyroid extension of the primary tumor and presence of distant metastases always precludes normalization of serum basal levels [6]. Postoperative normalization of serum calcitonin has been associated with an improved prognosis on multivariate analysis [13,16]. In the present series, each of the five symptomatic high-risk patients was relieved of their preoperative symptoms, but none of them accomplished biochemical cure.…”

“…In MTC, regional lymph-node metastases serve as the 'pacemaker' of the disease [11]. Thus, presence of lymph-node metastases portends a less favorable prognosis, accounting for local recurrences and increased fatality rates [12,13]. Survival rates are significantly worse in mediastinal lymph-node metastases, as opposed to negative or positive cervical lymph-node metastases only [4].…”

Stage-Specific Embryonic Antigen-1 (SSEA-1) Expression in Thyroid Tissues

“…This latter study also reported that there was also less SSEA-1 immunoreactivity observed in follicular variant of papillary thyroid carcinomas (FVPTCs) (12). The presence of SSEA-1 reactivity has been suggested as an unfavorable prognostic sign in thyroid medullary and papillary carcinoma (13-16). …”