Thyroid Papillary Carcinoma Clinical Pathological Characteristics And Significance Of Molecular Markers In Predicting Tumor Biological Behavior

Objectives:To evaluate the relationship between the behavior of papillary thyroid carcinoma and immunohistochemical results after the retrospectively study of248patients with papillary thyroid carcinoma for the clinicopathological characteristic and immunohistochemical results. And finally to distinguish the aggressive disease that bears significant morbidity and mortality by taking adventage of these two factors.Methods:This analysis included248patients with papillary thyroid carcinoma who were first diagnosed and underwent surgery at Cancer Hospital and Department of Oncology of Shanghai Medical College between Jan2011to June2011. The diagnosis was confirmed by the pathological histopathology and immunohistochemical examination. Clinical Information and immunohistochemical results were obtained. Univariate and multivariate analysis were performed to reveal the high-risk patients. Finally, the scoring system established on the basis of those useful factors would predict the behavior of papillary thyroid cancer.Results:Age over45years was the adverse prognostic factor for papillary thyroid cancer, whereas the initial presentation in young people demonstrates higher incidence of locoregional metastatic spread(p<0.05). Multivariate analysis showed that extrathyroidal extension(p<0.05) and p21(p<0.05) were strong independent predictors of bilateral papillary thyroid carcinomas. The incidence of people without extrathyroidal extension and low expression of p21presents with bilateral papillary thyroid carcinomas is9.9%. Multivariate analysis also found that the age(p<0.05), extrathyroidal extension(p<0.05) and p27(p<0.05) were strong independent predictors of papillary thyroid carcinomas presenting with lateral cervical lymph node metastasis. The incidence of lateral cervical lymph node metastasis for people who were sorted in High-risk group was90.9%. Conclusion:Ongoing debates in the treatment of patients with papillary thyroid cancer over the last several decades have focused on the extent of thyroidectomy and the extent of lymphadenectomy. Although the understanding of the biology of the papillary thyroid cancer is developed, the question is far way solved. Recently, establishing the system to select the high-risk patients draw more and more attention. This research showed that patients with extrathyroidal extension and overexpression of p21have the trend of bilateral oncogensis, meanwhile, patients with age<45, extrathyroidal extension and underexpression of p27presented lateral lymph node metastasis probably, who needed more aggressive therapy and follow up.