Poorly differentiated carcinoma of the thyroid: validation of the Turin proposal and analysis of IMP3 expression

Asioli, Sofia; Erickson, Lori A.; Righi, Alberto; Jin, Long; Volante, Marco; Jenkins, Sarah M.; Papotti, Mauro; Bussolati, Gianni; Lloyd, Ricardo V.

doi:10.1038/modpathol.2010.117

Cited by 156 publications

(164 citation statements)

References 28 publications

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“…They applied both immunohistochemistry and qRT PCR, and for both techniques, they concluded that the expression of IMP3 seems to be a bad prognostic sign for PDC (9).…”

Section: Discussionmentioning

confidence: 99%

“…An immunohistochemical score (IHC-score) was obtained by adding two scores (the lowest IHC score was 0 and the highest IHC score was 6); a score higher than 2 was considered positive, whereas a score 2 or lower was considered negative (9).…”

Section: Immunohistochemical Technique and Evaluationmentioning

confidence: 99%

“…Recently, IMP3, a member of the 'insulin-like growth factor II mRNA binding protein' family, has been presented as a potential diagnostic and prognostic tool for thyroid tumors (7)(8)(9).…”

mentioning

confidence: 99%

“…The authors concluded that IMP3 can be useful in distinguishing benign and malignant thyroid tumors (7)(8)(9).…”

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confidence: 99%

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Imp3 Expression in Benign and Malignant Thyroid Tumors and Hyperplastic Nodules

Kulaçoğlu¹,

Erkılınç²

2015

Balkan Med J

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Background: IMP3, a member of insulin-like growth factor II m RNA binding protein family, seems to be promising in the diagnosis of carcinomas of many organs as well as malignant melanomas and some sarcomas. It is postulated that it might be a marker of malignancy. The results of the few prior studies indicate that IMP3 has the potential to be useful in distinguishing benign and malignant tumors of thyroid. Aims: We aimed to evaluate the immunohistochemical expression of IMP3 in non-neoplastic nodules and benign and malignant tumors of the thyroid. Study Design: Diagnostic accuracy study. Methods: Overall, 92 thyroid lesions, including 22 nodular hyperplasia (NH), 14 follicular adenoma (FA), 9 follicular carcinoma (FC), 37 papillary carcinoma (PC) (15 follicular variant), 3 well differentiated carcinoma-not otherwise specified (WDC-NOS), 4 poorly differentiated carcinoma (PDC) and anaplastic carcinoma (AC) were included. Immunohistochemically, cytoplasmic expression of IMP3 was evaluated in terms of extent and intensity of the staining semi-quantitatively and an immunohistochemical score (IHS) was obtained for each case. A score higher than 2 was considered positive staining. Results: In contrast with previous studies, we observed positive staining in benign lesions, especially in benign tumors. For identifying malignant tumors, the sensitivity of IMP3 was 82.1%, specificity was 33.3%, positive predictive value (PPV) was 65.7% and negative predictive value (NPV) was 54.5%. In distinguishing neoplastic and hyperplastic lesions, the sensitivity was 50%, specificity was 15.7%, PPV was 15.7% and NPV was 50%. The IMP3 expression was similar for FA and well differentiated carcinomas (p=0.434), but there was a significant difference between hyperplastic nodules and FA (p=0.011). Conclusion: Our data suggest that IMP3 is effective in discriminating hyperplastic and neoplastic lesions but not useful in differentiating benign tumors from malignant tumors.

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“…They applied both immunohistochemistry and qRT PCR, and for both techniques, they concluded that the expression of IMP3 seems to be a bad prognostic sign for PDC (9).…”

Section: Discussionmentioning

confidence: 99%

Section: Immunohistochemical Technique and Evaluationmentioning

confidence: 99%

See 2 more Smart Citations

Imp3 Expression in Benign and Malignant Thyroid Tumors and Hyperplastic Nodules

Kulaçoğlu¹,

Erkılınç²

2015

Balkan Med J

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“…Interestingly, there are striking regional differences in PDTC incidence rates; Northern Italy has the highest rates (15 %) with much lower rates in the United States (1.8 %) and Japan (\1 %), suggesting a multifactorial causative interaction between genetics, environment, and diet [13]. A recent study has shown that insulin-like growth factor-I mRNA binding protein-3 (IMP3) expression in PDTC appears to be an adverse prognostic factor, in that in univariate analysis, the risk of death was higher for age C45, tumors C4 cm, and IMP3 positivity by immunohistochemistry [14]. IMP3 expression has been shown to have diagnostic and/or prognostic value in many malignant solid tumors, including thyroid [14].…”

Section: Dedifferentiationmentioning

confidence: 99%

When Thyroid Carcinoma Goes Bad: A Morphological and Molecular Analysis

Papp

Sylvia

2015

Head and Neck Pathol

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Thyroid carcinomas of follicular epithelial derivation are common and generally well-behaved malignancies with excellent cure and survival rates. However, a subset of these carcinomas, whether well-differentiated, poorly differentiated, or anaplastic, is highly aggressive, manifesting with local invasion, recurrence, and distant metastasis. The recognition of dedifferentiation is of paramount importance. In addition, the challenge for Pathologists is to identify the rare aggressive differentiated carcinomas so that treatment may be tailored appropriately. Thus, histological subtyping and documentation of other aggressive features such as widespread invasion and angioinvasion are critical. Mutational analyses in the past decade have delineated the molecular alterations responsible for thyroid carcinogenesis and progression, allowing greater sub-classification and prognostication of thyroid carcinomas. This review article highlights important aggressive morphologic features and molecular mutations associated with thyroid carcinoma.

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Insular thyroid cancer

Kazaure

Roman

Sosa

2012

Cancer

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BACKGROUND: Insular thyroid cancer (ITC) is an uncommon, poorly differentiated thyroid malignancy. To date, there have been no population-level studies of the characteristics and outcomes of patients with ITC. METHODS: The authors used the Surveillance, Epidemiology, and End Results (SEER) database from 1999 to 2007 to compare the characteristics and prognosis of patients who had ITC with those of patients who had well differentiated thyroid cancer (WDTC) and anaplastic thyroid cancer (ATC). Data analyses were performed using chi-square tests, analyses of variance, log-rank tests, and multivariate regression. RESULTS: There were 114 patients with ITC, 497 patients with ATC, and 34,021 patients with WDTC. The mean age of patients with ITC was 62.1 years versus 48.1 years for patients with WDTC and 69.5 years for patients with ATC (P < .001). The mean ITC tumor size was 5.9 cm versus 2.0 cm for WDTC and 6.4 cm for ATC (P < .001). Distant metastasis occurred in 31% of patients with ITC versus 4.5% of patients with WDTC and 59.1% of patients with ATC (P < .001). Insular histology was associated independently with compromised survival in the overall study sample (hazard ratio [HR], 2.1; P ¼ .001). The 5-year disease-specific survival rate was 72.6%, 97.2%, and 9.1% for patients with ITC, WDTC, and ATC, respectively (P < .001). After adjustment, radioiodine therapy (HR, 0.15; 95% confidence interval, 0.04-0.5) and distant metastasis (HR, 15.3; 95% confidence interval, 3.7-62.2) were associated independently with ITC survival. The mortality rate was 7.1%, 12%, and 54.3% for patients with localized, regional, and distant stage ITC, respectively (P < .001). For patients who had ITC with distant metastasis, thyroidectomy and radioiodine therapy independently improved survival. CONCLUSIONS: ITC is rare and aggressive. The current results indicated that its treatment should include total thyroidectomy and high-dose radioiodine for all patients and neck dissections for patients with lymph node disease. Early diagnosis and close surveillance are essential in the management of patients with ITC. Cancer 2012;118:3260-7.

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Poorly differentiated carcinoma of the thyroid: validation of the Turin proposal and analysis of IMP3 expression

Cited by 156 publications

References 28 publications

Imp3 Expression in Benign and Malignant Thyroid Tumors and Hyperplastic Nodules

Imp3 Expression in Benign and Malignant Thyroid Tumors and Hyperplastic Nodules

When Thyroid Carcinoma Goes Bad: A Morphological and Molecular Analysis

Insular thyroid cancer

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