ABSTRACT
CD44 was detected with an antibody recognizing all forms of CD44 (CD44 standard) and others specific for its v3 and v6 variant isoforms; their prognostic value was evaluated in 213 patients with differentiated thyroid carcinoma (DTC). The staining patterns of CD44 standard (s) and CD44v6 in tumour tissue were quite similar, 176 cases (83%) being highly positive for CD44s and 153 cases (72%) for CD44v6. Only 18 (9%) tumours showed high expression of CD44v3. Papillary carcinomas were significantly more often high expressors of CD44s and CD44v6 than follicular carcinomas (p<0.001 for both). Age older than 60 years, distant metastases, and advanced pTNM stage were related to loss of expression of CD44s (p<0.001, p=0.021, and p=0.003, respectively). Tumour recurrence and cancer-related mortality were related to the reduced level of CD44s (p=0.049 and p=0.042). CD44v3 did not associate with any of the clinicopathological factors. In univariate analysis, CD44s was the only significant prognostic factor for disease-free survival (p=0.0488). In multivariate analysis, CD44s and thyroglobulin level were significant prognostic factors for disease-free survival (p=0.040 and p<0.001, respectively). The reduced level of CD44s in DTC patients seems to be an independent prognostic factor for unfavourable disease outcome.
Subject(s)
Carcinoma, Papillary, Follicular/immunology , Hyaluronan Receptors/immunology , Neoplasm Recurrence, Local/immunology , Thyroid Neoplasms/immunology , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Biomarkers, Tumor , Carcinoma, Papillary, Follicular/secondary , Child , Disease-Free Survival , Female , Humans , Male , Middle Aged , Multivariate Analysis , Neoplasm Metastasis/immunology , Prognosis , Thyroglobulin/analysis , Thyroid Neoplasms/pathology , Thyroid Neoplasms/surgery , Thyroidectomy/methodsABSTRACT
A 37-year-old woman presented with hoarseness two days after developing pain while undergoing physiotherapy for tension in her neck. Computed tomography showed a probably benign mass near to the left lobe of the thyroid, which was found at operation to be attached to the recurrent laryngeal nerve. The nerve was dissected free, the tumour removed, and the patient and her voice recovered fully. Histological examination confirmed a benign cyst in extraglandular thyroid tissue and the patient is well two years later.
