Downregulation of p27KIP1 and Ki67/Mib1 labeling index support the classification of thyroid carcinoma into prognostically relevant categories

被引:106
作者
Tallini, G
Garcia-Rostan, G
Herrero, A
Zelterman, D
Viale, G
Bosari, S
Carcangiu, ML
机构
[1] Yale Univ, Sch Med, Dept Pathol, New Haven, CT 06520 USA
[2] Yale Univ, Sch Med, Dept Epidemiol & Publ Hlth, New Haven, CT 06520 USA
[3] European Inst Oncol, Div Pathol & Lab Med, Milan, Italy
[4] Univ Oviedo, Dept Pathol, Oviedo, Spain
关键词
thyroid; carcinoma; p27(KIP1); Ki67/Mib1; cellular proliferation; tumor differentiation; tumor classification;
D O I
10.1097/00000478-199906000-00007
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
The cyclin-dependent kinase inhibitor p27(KIP1) has been proposed as a valuable prognostic indicator for a variety of human neoplasms. Immunohistochemical reactivity for p27(KIP1) and the proliferation marker Ki67/Mib1 were investigated in 90 thyroid carcinomas of follicular cell origin. The neoplasms were divided into three prognostic groups on the basis of their morphologic features: group I, well-differentiated papillary or follicular carcinomas with favorable pathologic features (43 papillary carcinomas and 4 minimally invasive follicular carcinomas); group 2, papillary or follicular carcinomas with unfavorable pathologic features (21 poorly differentiated carcinomas and 2 papillary carcinomas, tall cell variant); and group 3, undifferentiated, or anaplastic, carcinomas, p27(KIP1) expression (p = 0.007) and Ki67/Mib1 labeling index (p = 0.07) showed a strong correlation with the subdivision of the thyroid carcinomas in the three prognostic groups with a significant linear trend for tumors with low p27(KIP1) (P = 0.002) and high Ki67/Mib1 labeling index (p = 0.005) to segregate into the unfavorable categories (groups 3, and 3). Low p27(KIP1) expression, but not cellular proliferation, was related to adverse prognostic factors, such as large tumor size (p = 0.03) and extrathyroidal extension (p = 0.01), but the correlation was not independent of the subdivision in the three groups. Low p27(KIP1) expression (p = 0.03) and high proliferative rate (p = 0.02) were associated with poor survival, reflecting the close association between patient morbidity and mortality rates and tumor differentiation. No significant association could be seen between p27(KIP1) or cellular proliferation and clinicopathologic parameters (e.g., age, sex, tumor size, extrathyroidal extension, vascular invasion, lymph node metastases, distant metastases, tumor stage, and survival rate) within any of the groups, or the histologic diagnosis of papillary versus follicular carcinoma irrespective of their degree of differentiation, Modulation of p27(KIP1) and cellular proliferation patterns in thyroid carcinoma correlate with tumor differentiation and support the morphologic classification of thyroid carcinoma into prognostically relevant categories.
引用
收藏
页码:678 / 685
页数:8
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