1Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
2Department of Surgery, Chung-Ang University College of Medicine, Seoul, Korea
3Department of Radiology, Chung-Ang University College of Medicine, Seoul, Korea
4Department of Pathology, Chung-Ang University College of Medicine, Seoul, Korea
Copyright © 2021 by the Korean Cancer Association
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.
Ethical Statement
The study protocol was approved by the institutional review board of Chung-Ang University Hospital (IRB No 1900-004-389). Patients agreed to use their tissues for molecular study and secondary use in the other studies.
Author Contributions
Conceived and designed the analysis: Ahn HY, Song RY, Ahn HS, Kim HS.
Collected the data: Ahn HY, Kim HS.
Contributed data or analysis tools: Ahn HY, Kim HS.
Performed the analysis: Ahn HY.
Wrote the paper: Ahn HY, Kim HS.
Conflicts of Interest
Conflict of interest relevant to this article was not reported.
Clinicopathological features of total study subjects
Characteristic | No. (%) (n=436) |
---|---|
Follow-up, median (interquartile range, yr) | 6.8 (6.2–7.0) |
Age (yr) | 46.1±12.4 |
Tumor size (cm) | 1.06±0.78 |
Papillary microcarcinoma (< 1 cm) | 260 (59.6) |
Male sex | 95 (21.8) |
Total thyroidectomy | 412 (94.5) |
10% LN metastasis buff | 243 (55.7) |
Lymphatic invasion | 5 (1.1) |
Blood vessel invasion | 3 (0.7) |
Multiplicity | 180 (41.3) |
Extrathyroidal extension (micro/gross) | 130 (29.8)/12 (2.8) |
BRAFV600E mutation | 316 (72.5) |
Recurrence | 9 (2.1) |
ER α | 176 (40.4) |
ER β1 | 365 (83.7) |
PR | 311 (71.3) |
EGFR | 84 (19.3) |
ER, estrogen receptor; LN, lymph node; PR, progesterone receptor; EGFR, epidermal growth factor.
Clinicopathological characteristics according to the positivity of estrogen and progesterone receptors in papillary thyroid carcinoma
ER α (−) | ER α (+) | p-value | ER β1 (−) | ER β1 (+) | p-value | PR (−) | PR (+) | p-value | |
---|---|---|---|---|---|---|---|---|---|
No. (%) | 260 (59.6) | 176 (40.4) | 64 (14.9) | 365 (85.1) | 125 (28.7) | 311 (71.3) | |||
Follow-up duration (yr) | 6.1±1.8 | 6.4±3.0 | 0.107 | 6.0±1.9 | 6.2±2.4 | 0.519 | 6.3±3.6 | 6.2±1.7 | 0.819 |
Age (yr) | 47.1±12.5 | 44.6±12.1 | 0.040 | 45.5±12.7 | 46.3±12.3 | 0.608 | 43.5±12.4 | 47.2±12.3 | 0.005 |
Tumor size (cm) | 1.13±0.82 | 0.96±0.69 | 0.020 | 1.03±0.59 | 1.07±0.81 | 0.665 | 1.07±0.81 | 1.06±0.77 | 0.906 |
Male sex | 51 (19.6) | 44 (25.0) | 0.181 | 8 (12.5) | 86 (23.6) | 0.048 | 28 (22.4) | 67 (21.5) | 0.845 |
LN metastasis | 137 (52.7) | 106 (60.2) | 0.120 | 31 (48.4) | 208 (57.0) | 0.204 | 67 (53.6) | 176 (56.6) | 0.570 |
Lymphatic invasion | 3 (1.2) | 2 (1.1) | 0.987 | 1 (1.6) | 4 (1.1) | 0.748 | 1 (0.8) | 4 (1.3) | 0.666 |
Blood vessel invasion | 3 (1.2) | 0( | 0.153 | 0 ( | 3 (0.8) | 0.467 | 1 (0.8) | 2 (0.6) | 0.858 |
Multiplicity | 103 (39.6) | 77 (43.8) | 0.390 | 28 (43.8) | 148 (40.5) | 0.631 | 54 (43.2) | 126 (40.5) | 0.607 |
Extrathyroidal extension (micro/gross) | 78 (30.3)/9 (3.5) | 52 (29.5)/3 (1.7) | 0.532 | 19 (29.7)/1 (1.6) | 109 (29.9)/11 (3.0) | 0.806 | 36 (28.8)/3 (2.4) | 94 (30.2)/9 (2.9) | 0.910 |
BRAFV600E mutation | 186 (71.5) | 130 (73.9) | 0.594 | 45 (70.3) | 268 (73.4) | 0.605 | 94 (75.2) | 222 (71.4) | 0.420 |
ER α positivity | - | - | - | 21 (32.8) | 159 (43.6) | 0.108 | 34 (27.2) | 142 (45.7) | < 0.001 |
ER β positivity | 211 (81.2) | 154 (87.5) | 0.100 | - | - | - | 87 (72.5) | 278 (90.0) | < 0.001 |
PR positivity | 169 (65.0) | 142 (80.7) | < 0.001 | 31 (48.4) | 284 (77.8) | < 0.001 | - | - | - |
EGFR overexpression | 36 (13.8) | 48 (27.3) | < 0.001 | 15 (23.4) | 67 (18.4) | 0.388 | 26 (20.8) | 58 (18.6) | 0.607 |
p27 positivity | 16 (6.3) | 33 (18.3) | < 0.001 | 4 (6.3) | 43 (11.7) | 0.401 | 8 (6.5) | 41 (13.1) | 0.117 |
Recurrence | 6 (2.4) | 3 (1.7) | 0.661 | 1 (1.6) | 8 (2.2) | 0.757 | 1 (0.8) | 8 (2.6) | 0.248 |
Values are presented as number (%) or mean±SD. EGFR, epidermal growth factor; ER, estrogen receptor; LN, lymph node; PR, progesterone receptor; SD, standard deviation.
Clinicopathological characteristics according to the combination of ER α and β1 positivity
ER α (−) ERβ1 (+) | ER α (+) ERβ1 (+) | ER α (−) ERβ1 (−) | ER α (+) ERβ1 (−) | p-value | |
---|---|---|---|---|---|
No. (%) | 211 (49.2) | 154 (35.9) | 44 (10.3) | 20 (4.7) | |
Follow-up duration | 6.0±1.8 | 6.5±3.1 | 6.1±1.9 | 5.9±2.3 | 0.249 |
Age | 47.4±12.5 | 44.8±11.8 | 45.8±12.4 | 44.8±13.7 | 0.225 |
Tumor size | 1.14±0.86 | 0.98±0.73 | 1.11±0.65 | 0.87±0.38 | 0.140 |
Male sex | 44 (20.9) | 42 (27.3) | 6 (13.6) | 2 (10.0) | 0.105 |
LN metastasis | 116 (55.0) | 92 (59.7) | 19 (43.2) | 12 (60.0) | 0.261 |
Lymphatic invasion | 2 (0.9) | 2 (1.3) | 1 (2.3) | 0 | 0.846 |
Blood vessel invasion | 3 (1.4) | 0 ( | 0 ( | 0 ( | 0.373 |
Multiplicity | 84 (39.8) | 64 (41.6) | 17 (38.6) | 11 (55.0) | 0.601 |
Extrathyroidal extension (micro/gross) | 62/9 (29.4/4.3) | 47/2 (30.5/1.3) | 14/0 (31.8/0) | 5/1 (25.0/5.0) | 0.574 |
BRAFV600E mutation | 153 (72.5) | 115 (74.7) | 31 (70.5) | 14 (70.0) | 0.923 |
PR positivity | 147 (71.4) | 137 (86.2) | 21 (48.8) | 10 (47.6) | < 0.001 |
EGFR overexpression | 30 (14.2) | 37 (24.0) | 5 (11.4) | 10 (50.0) | < 0.001 |
p27 positivity | 12 (5.7) | 31 (20.1) | 2 (4.5) | 2 (10.0) | 0.001 |
Recurrence | 5 (2.4) | 3 (2.0) | 1 (2.3) | 0 | 0.897 |
Values are presented as number (%) or mean±SD. EGFR, epidermal growth factor; ER, estrogen receptor; LN, lymph node; PR, progesterone receptor; SD, standard deviation.
Positivity of ER, PR, and EGFR according to sex and age of female
Male (n=95) | Female (n=341) | p-value | Female (< 50 yr) (n=198) | Female (≥ 50 yr) (n=143) | p-value | |
---|---|---|---|---|---|---|
ERα positivity | 44/95 (46.3) | 132/341 (38.7) | 0.181 | 78/198 (39.4) | 54/143 (37.8) | 0.760 |
ERβ1 positivity | 86/94 (91.5) | 279/335 (83.3) | 0.048 | 158/194 (81.4) | 121/141 (85.8) | 0.290 |
PR positivity | 67/95 (70.5) | 244/341 (71.6) | 0.845 | 132/198 (66.7) | 112/143 (78.3) | 0.019 |
EGFR overexpression | 17/95 (17.9) | 67/341 (19.6) | 0.702 | 46/198 (23.2) | 21/143 (14.7) | 0.050 |
Values are presented as number (%) or mean±SD. EGFR, epidermal growth factor; ER, estrogen receptor; PR, progesterone receptor; SD, standard deviation.
Multivariate Cox’s proportional hazard analysis for the recurrence of papillary thyroid carcinoma
p-value | Hazard ratio | 95% Confidence interval | |
---|---|---|---|
Age at diagnosis | 0.577 | 1.017 | 0.958–1.081 |
Male sex | 0.013 | 5.864 | 1.462–23.523 |
Size | 0.008 | 1.867 | 1.174–2.970 |
ERα positivity | 0.609 | 0.684 | 0.159–2.935 |
ERβ1 negativity | 0.946 | 1.079 | 0.118–9.890 |
EGFR positivity | 0.793 | 0.735 | 0.074–7.332 |
BRAFV600E mutation | 0.548 | 1.947 | 0.221–17.135 |
LN metastasis | 0.493 | 1.863 | 0.314–11.059 |
Lymphatic invasion | 0.020 | 15.810 | 1.537–162.626 |
Extrathyroidal extension | 0.976 | 1.024 | 0.217–4.828 |
Multiplicity | 0.300 | 2.112 | 0.514–8.682 |
EGFR, epidermal growth factor; ER, estrogen receptor; LN, lymph node.
ER, estrogen receptor; LN, lymph node; PR, progesterone receptor; EGFR, epidermal growth factor.
Values are presented as number (%) or mean±SD. EGFR, epidermal growth factor; ER, estrogen receptor; LN, lymph node; PR, progesterone receptor; SD, standard deviation.
Values are presented as number (%) or mean±SD. EGFR, epidermal growth factor; ER, estrogen receptor; LN, lymph node; PR, progesterone receptor; SD, standard deviation.
Values are presented as number (%) or mean±SD. EGFR, epidermal growth factor; ER, estrogen receptor; PR, progesterone receptor; SD, standard deviation.
EGFR, epidermal growth factor; ER, estrogen receptor; LN, lymph node.