Immunohistochemical characteristics of diffuse sclerosing variant of papillary carcinoma: comparison with conventional papillary carcinoma

Abstract

Diffuse sclerosing variant of papillary carcinoma (DSVPC) is a rare variant of papillary thyroid carcinoma (PTC). It shows different clinicopathologic features to the conventional PTC, but the immunohistochemical characteristics of DSVPC are yet to be more clearly defined. The purpose of this study was to investigate the immunohistochemical features of DSVPC, which are different from those of PTC. Tissue microarray was constructed from the paraffin-embedded tissue of 49 DSVPC and 50 conventional PTC samples. Immunohistochemical stains for p63, p53, galectin-3, cytokeratin 19, β-catenin, Bcl-2, EMA, E-cadherin, CD15, and CD56 were performed on each tissue microarray. Immunohistochemical stain for p63 was negative in all conventional PTCs, but 14 (28.6%) cases of DSVPC showed p63 expression (p = 0.000). p53 was expressed in 38 (76.0%) cases of conventional PTC and 21 (42.9%) cases of DSVPC (p = 0.001). Galectin-3 was expressed in all 50 cases of conventional PTC, but eight (16.3%) cases of DSVPC did not express galectin-3 (p = 0.003). EMA was expressed more in DSVPC (40.8%) than in conventional PTC (20.0%, p = 0.024). In univariate analyses, Bcl-2 positivity (p = 0.016) and EMA negativity (p = 0.036) in DSVPC were associated with shorter time interval to tumor recurrence, but there was no significance for the two in multivariate analyses. DSVPC, a rare variant of PTC, has different immunohistochemical features from the conventional PTC, showing higher expression rate of p63 and lower expression rate of p53. It also shows galectin-3 negativity and EMA positivity.

Diffuse sclerosing variant of papillary thyroid carcinoma—an update of its clinicopathological features and molecular biology

“…Furthermore, positive bcl-2 protein expression in DSVPTC has been reported to be associated with early cancer recurrence. The study by Koo et al also showed relatively lower prevalence of galectin-3 protein expression in DSVPTC (83.7%, 41 of 49) compared to conventional PTC (100%, 50 of 50) [25]. Both bcl-2 and EMA are associated with cancer aggressiveness.…”

“…These findings suggested that squamous metaplasia in DSVPTC arises from thyroid follicular epithelial cells [33]. In addition, Koo et al, showed higher protein expression of epithelial membrane antigen (EMA) in DSVPTC (40.8%) than in conventional PTC (20.0%) [25]. Furthermore, positive bcl-2 protein expression in DSVPTC has been reported to be associated with early cancer recurrence.…”

“…Lung was noted as the commonest site of distant metastasis in many studies [18,23,25,32]. Other sites of metastases included the bone, brain, liver and pericardium [18,32,47].…”

Expression of Caveolin-1, Caveolin-2 and Caveolin-3 in Thyroid Cancer and Stroma

“…As caveolin-3 is specifically expressed in myocytes, it could be postulated that AC may acquire a myogenic phenotype as part of the EMT process and hence express caveolin-3. DSVPC, on the other hand, has been frequently associated with younger age at diagnosis, extensive lymph node metastasis, frequent local recurrence and distant metastasis compared to conventional PTC, as also shown in this study [3,25,26] . However, although DSVPC is associated with features of invasiveness, suggesting that EMT may play a considerable role, the expression of caveolin-3 was rare (4.9%) in DSVPC in contrast to AC.…”

Clinical Workup of Nodular and Mass Lesions of the Endocrine Organs

“…Thyroid follicular neoplasms and medullary carcinomas are positive for TTF-1. Conventional papillary thyroid carcinoma is immunoreactive for p53 (76%), galectin-3 (100%), and EMA (50%), while are negative for p63 (Koo, Shin et al 2010). Diffuse sclerosing variant of papillary carcinoma is immunohistochemically positive for p63 (28.6%), p53 (42.9%) galectin-3 (16.3%), EMA (40.8%) (Koo, Shin et al 2010), and BCL-2 (Koo, Shin et al 2010).…”