Expression of Ki67 in Papillary Thyroid Microcarcinoma and its Clinical Significance

Zhang, Yuan; Jiang, Honggang; Lü, Ning; Lu, Bo-hao; Chen, Zhiheng

doi:10.7314/apjcp.2015.16.4.1605

Cited by 30 publications

(30 citation statements)

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“…Therefore, a preoperative analysis of Ki-67 LI by fine needle aspiration may be useful for determining an appropriate PTMC management strategy in the future. It was previously reported that high Ki-67 LI in PTMC was related to nodal metastasis [20]. However, our results did not support these findings.…”

Section: Discussioncontrasting

confidence: 57%

Pathological characteristics of low-risk papillary thyroid microcarcinoma with progression during active surveillance

et al. 2016

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Section: Discussioncontrasting

confidence: 57%

Pathological characteristics of low-risk papillary thyroid microcarcinoma with progression during active surveillance

et al. 2016

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“…We have found a negative correlation between SR5 expression and ki67 percentage. Whereas high ki67 proliferation index is an important prognostic factor in many tumors (Kilickap et al,2014;Zhou et al, 2015) , it has a special importance in GN. The reason is that the percentage of ki67 proliferation index is used in grading and the determination whether to give chemotherapy in GN (Rindi et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

“…Ki67 indicates active cells during cell cycle. It is an important cell marker that shows cell proliferation and is an important prognostic factor for various malignancies (Kilickap et al,2014;Zhou et al, 2015). Additionally the percentage of ki67 proliferation is an important parameter in World Health Organization (WHO) 2010 classification of GN (Rindi et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Somatostatin Receptor 2 and 5 Expressions in Gastroenteropancreatic Neuroendocrine Tumors in Turkey

Yerci

Şehitoğlu²,

Uğraş³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: Gastroenteropancreatic neuroendocrine tumors (GNs) are slow growing and although their incidence has increased in recent years, they are relatively rarely seen. Somatostatin analogues are used in the treatment of GNs that express somatostatin receptor (SR). We aimed to investigate the expression of SR2 and SR5 in GNs. Materials and Methods: In this study the expression of SR2 and SR5 was investigated immunohistochemically in 49 cases (26 males, 23 females) diagnosed and graded with GN according to the World Health Organization classification 2010. Results: The percentage of SR2 staining was 91.0% in grade 1, 82.8% in grade 2 and 100% in grade 3. On the other hand, the percentage of SR5 staining was 81.8% % in grade 1, 60.0% in grade 2 and 0% in grade 3. According to the tumor localization, the percentages of SR2 expression were as follows: pancreas 85.7%, stomach 100%, small bowel 70%, appendix 85.7% and rectum 100%. The percentages of SR5 expression were: pancreas 61,9%, stomach 37.5%, small bowel 70%, appendix 71.5% and rectum 66.6%. There was a significant negative correlation between ki67 percentage and SR5 expression (r=-0.341, p=0.016). Conclusions: In this study, GNs were found to highly express SR2 and SR5. Although the expression of SR2 and SR5 changed according to tumor localization, the expression of SR2 was higher than the expression of SR5 in GN. There was a significant negative correlation between ki67 and SR5. Accordingly, SR5 may be a prognostic indicator of GN.

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“…12 Molecular markers (BRAF, PIK3CA, AKT1, TERT, TP53) may be useful in the future for prognostic stratification, especially the coexistence of these markers [13][14][15][16] as well as the expression of the Ki67 protein, which is associated with PTMC size, tumor invasion, lymph node metastasis, and may be used in the future as a monitoring and a clinical decision parameter. 17 In the group of patients with low-risk PTMC that demand surgery during the follow-up (<10% of cases), it does not impact on the outcome. Therefore, our conduct for a patient diagnosed with a PTMC and all the low-risk criteria (outlined above), such as over 40 years of age, without history of head and neck radiation, nor family history of thyroid cancer, is active surveillance.…”

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confidence: 97%

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2016

EMIJ

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The referred ATA Guideline 1 eliminates the biopsy from the management of the sub centimeter nodules, suggesting repetition of sonography every 6-12 months. The committee justified this action, to indicate FNAB only for suspicious nodules above 1cm, by the indolence of the papillary thyroid microcarcinoma (PTMC) and because these tumors rarely present ETE, cervical lymph node or distant metastasis, especially in individuals over 60 years of age [patients younger than 40 years are at increased risk for tumor growth (5.9%) and cervical lymph node metastasis (2.2%), when compared to those over 60 years, 5.3% and 0.4%, respectively; p <0.05]. 2 We, however, advocate the realization of the FNAB in all sub centimeter nodules of suspected malignancy, if technically possible, to guide and optimize the follow-up thereof. Considering the high probability of malignancy of these nodules (70% -90%) 3 not performing FNAB would most likely only delay or hide a probable diagnosis. Furthermore, we consider as the main argument for our conduct, the citological fends off the small but existing possibility of FNAB findings of high-grade malignancy. Similar thought is shared by the Korean guideline, 4 which argues that this strategy can avoid unnecessary long-term active surveillance in 20 to 40% of cases and that the FNAB findings of high-grade malignancy may even change the management strategy from active surveillance to surgery, although such cases are rare.However, we are aware that over diagnosis has been the source of the alerted thyroid cancer epidemic and agree with the risks associated with the overtreatment of these patients, when conducted in a wreckless manner.5 Here upon, two Japanese 2,6 prospective studies support the active surveillance as a management strategy of low risk PTMC as an alternative to surgical treatment.Ito et al., 2 followed 1235 patients with PTMC for an average of 60 months (18-227 months). They observed tumor growth of >3mm in sonography in 5% (5 years) and 8% (10 years); lymph node metastasis in 1.7% (5 years) and in 3.8% (10 years); need for surgery during follow-up in 15% (191/1235); progression to clinical disease (increase of >12 mm or lymph node metastasis) in 3.5%. Interestingly, the progression rate was inversely proportional to the age of patients, being 8.9% younger than 40 years, 3.5% aged between 40 and 60 years and 1.6% in patients over 60 years-old. Sugitani et al.,6 followed 230 patients with PTMC for an average of 11 years. The rates of tumor growth, lymph node metastasis and surgical intervention were of 7%, 1% and 7%, respectively, at the end of the period.More recently, Brito et al., 7 proposed an interesting decision making approach to assess the applicability of active surveillance, taking into account tumor and patient variables, as well as staff/ medical resources. In this study, they reinforce the excellent results seen in active surveillance at the Kuma Hospital as a result of a careful and thorough selection of patients by an experienced team in thyroid cancer with easy acc...

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Expression of Ki67 in Papillary Thyroid Microcarcinoma and its Clinical Significance

Cited by 30 publications

References 10 publications

Pathological characteristics of low-risk papillary thyroid microcarcinoma with progression during active surveillance

Pathological characteristics of low-risk papillary thyroid microcarcinoma with progression during active surveillance

Somatostatin Receptor 2 and 5 Expressions in Gastroenteropancreatic Neuroendocrine Tumors in Turkey

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