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Does the site of origin of the microcarcinoma with respect to the thyroid surface matter? A multicenter pathologic and clinical study for risk stratification

Title: Does the site of origin of the microcarcinoma with respect to the thyroid surface matter? A multicenter pathologic and clinical study for risk stratification
Authors: Tallini G.; De Leo A.; Repaci A.; de Biase D.; Reggiani M. L. B.; Di Nanni D.; Ambrosi F.; Di Gioia C.; Grani G.; Rhoden K. J.; Solaroli E.; Monari F.; Filetti S.; Durante C.
Contributors: Tallini, G.; De Leo, A.; Repaci, A.; de Biase, D.; Reggiani, M. L. B.; Di Nanni, D.; Ambrosi, F.; Di Gioia, C.; Grani, G.; Rhoden, K. J.; Solaroli, E.; Monari, F.; Filetti, S.; Durante, C.
Publisher Information: MDPI AG; Postfach
Publication Year: 2020
Collection: Sapienza Università di Roma: CINECA IRIS
Subject Terms: Papillary carcinoma prognosi; papillary microcarcinoma; risk stratification; thyroid capsule; thyroid nodule; tumor diameter; tumor location; tumor origin
Description: It is unclear whether the site of origin of papillary thyroid microcarcinoma (mPTC) with respect to the thyroid surface has an influence on clinicopathologic parameters. The objectives of the study were to: (i) Accurately measure the mPTC distance from the thyroid surface; (ii) analyze whether this distance correlates with relevant clinicopathologic parameters; and (iii) investigate the impact of the site of origin of the mPTC on risk stratification. Clinicopathologic features and BRAF mutational status were analyzed and correlated with the site of origin of the mPTC in a multicenter cohort of 298 mPTCs from six Italian medical institutions. Tumors arise at a median distance of 3.5 mm below the surface of the thyroid gland. Statistical analysis identified four distinct clusters. Group A, mPTC: size ≥ 5 mm and distance of the edge of the tumor from the thyroid capsule = 0 mm; group B, mPTC: size ≥ 5 mm and distance of the edge of the tumor from the thyroid capsule > 0 mm; group C, mPTC: size < 5 mm and distance of the edge of the tumor from the thyroid capsule=0 mm; and group D, mPTC: size < 5 mm and distance of the edge of the tumor from the thyroid capsule > 0 mm. Univariate analysis demonstrates significant differences between the groups: Group A shows the most aggressive features, and group D the most indolent ones. By multivariate analysis, group A tumors are characterized by tall cell histotype, BRAF V600E mutation, tumor fibrosis, aggressive growth with invasive features, vascular invasion, lymph node metastases, and intermediate ATA risk. The mPTC clinicopathologic features vary according to the tumor size and distance from the thyroid surface. A four-group model may be useful for risk stratification and to refine the selection of nodules to be targeted for fine needle aspiration.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/31963890; info:eu-repo/semantics/altIdentifier/wos/WOS:000516826700245; volume:12; issue:1; journal:CANCERS; http://hdl.handle.net/11573/1358750
DOI: 10.3390/cancers12010246
Availability: http://hdl.handle.net/11573/1358750; https://doi.org/10.3390/cancers12010246
Rights: info:eu-repo/semantics/openAccess
Accession Number: edsbas.3174F4D1
Database: BASE