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Clinical Characteristics and Prognosis of Differentiated Thyroid Carcinoma with Small Foci of Anaplastic Transformation
Int J Thyroidol 2017;10(2):96-101
Published online November 30, 2017;  https://doi.org/10.11106/ijt.2017.10.2.96
© 2017 Korean Thyroid Association.

Hwa Young Ahn1, Kyeong Choen Jung2, Do Joon Park3, Young Joo Park3 and Bo Youn Cho1

Department of Internal Medicine, Chung-Ang University College of Medicine1, Departments of Pathology2, Internal Medicine3, Seoul National University College of Medicine, Seoul, Korea
Correspondence to: Young Joo Park, MD, PhD, Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea
Tel: 82-2-2072-4183, Fax: 82-2-764-2199, E-mail: yjparkmd@snu.ac.kr
Received November 14, 2017; Revised November 21, 2017; Accepted November 22, 2017.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background and Objectives: Anaplastic thyroid carcinoma (ATC) is commonly related with concurrent differentiated thyroid carcinoma (DTC). We aimed to examine the clinicopathologic characteristics, prognosis and gene expression of DTC with anaplastic foci. Materials and Methods: Eighteen patients with DTC with anaplastic foci were enrolled in this study. To compare the clinicopathologic characteristics and prognosis of anaplastic foci subjects with conventional ATC or DTC, we additionally included 12 ATC and 1030 DTC patients who diagnosed during same period. Immunohistochemistry was performed to check the gene expression in anaplastic foci and DTC component. Results: In anaplastic foci group, tumor size was larger (2.5±1.3 vs. 1.2±0.9 cm, p=0.001), distant metastasis was more frequent (11.1 vs. 0%, p=0.000) and 1-year survival rate was low (88.9 vs. 100%, p=0.000) than DTC group. In contrast, compared with ATC group, anaplastic foci group showed younger age at diagnosis (50±16 vs. 63±18 years, p=0.039), smaller tumor size (2.5±1.3 vs. 3.8±1.4 cm, p=0.027), less distant metastasis (11.1 vs. 41.7%, p=0.084) and longer 1-year survival rate (88.9 vs. 25.0%, p=0.001). Expression of p53 protein was observed in 100% of anaplastic foci, ATC and 12.5% of papillary thyroid carcinoma component. Conclusion: DTC with foci of anaplastic transformation has a worse prognosis than DTC, but a better prognosis than ATC. Our results support that DTC with anaplastic foci was intermediate state from DTC to ATC.
Keywords : Thyroid carcinoma, Anaplastic, Thyroid neoplasm, Tumor suppressor protein p53, Prognosis


November 2017, 10 (2)