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Rocha ML, Schmid KW, Czapiewski P. The prevalence of DNA microsatellite instability in anaplastic thyroid carcinoma - systematic review and discussion of current therapeutic options. Contemp Oncol (Pozn) 2021; 25:213-223. [PMID: 34729042 PMCID: PMC8547184 DOI: 10.5114/wo.2021.110052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 09/25/2021] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Anaplastic thyroid carcinoma is a rare, rapidly progressing, highly aggressive thyroid malignancy. Responses to immune checkpoint inhibitors in mismatch repair-deficient/microsatellite instability-high tumours of other locations have shown promising results, and with the extended approval of the PD-1 receptor inhibitor pembrolizumab by the Food and Drug Administration, also anaplastic thyroid cancer (ATC) requires analysis for microsatellite instability (MSI) status. MATERIAL AND METHODS Systematic research for relevant literature was conducted in different databases. Prevalence, detection methods, and the potential prognostic/predictive value of MSI in view of the available targeted therapies were of special focus. RESULTS Selected citations revealed the prevalence of MSI in 7.4%, with mutations in the MSH2 gene (33%) being the most frequent, followed by MSH6 (25%) and MLH1 (16.7%) occurring in the following combinations: MLH1-MSH2 (8.3%), MSH2-MSH6 (8.3%), and MLH3-MSH5 (8.3%). No mutations in the PMS2 gene were reported. Sixty-six co-mutations in 9 cases were found, with TP53 (88.9%), NF1 (44.4 %), ATM (33.3%), and RB1 (33.3%) being the most frequent. No RAS mutations were noted. Survival ranged between 2.8 and 48 months, and patient age varied between 49 and 84 years. There are insufficient and heterogenous data concerning the predictive or prognostic value of mismatch repair-deficient/microsatellite instability status. CONCLUSIONS Tumour molecular profiling is fundamental in ATC for predictive, prognostic, as well as therapeutic reasons, and analysis of MSI status is strongly suggested because a small subgroup show the MSI signature and might profit from recently approved targeted therapies.
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Affiliation(s)
- Maria Linda Rocha
- Institute of Pathology Königs Wusterhausen, Königs Wusterhausen, Germany
| | - Kurt Werner Schmid
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Piotr Czapiewski
- Institute of Pathology, Dessau Medical Centre, Dessau, Germany
- Institute of Pathology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
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Migdalska-Sęk M, Czarnecka KH, Kusiński M, Pastuszak-Lewandoska D, Nawrot E, Kuzdak K, Brzeziańska-Lasota E. Clinicopathological Significance of Overall Frequency of Allelic Loss (OFAL) in Lesions Derived from Thyroid Follicular Cell. Mol Diagn Ther 2019; 23:369-82. [PMID: 30747408 DOI: 10.1007/s40291-019-00387-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Loss of heterozygosity (LOH) and microsatellite instability (MSI) are frequent molecular events in thyroid tumor etiopathogenesis occurring in several chromosomal critical areas, including 3p12–25.3, 7q21–31, 10q22–24, and 15q11–13, with loci of tumor suppressor genes. Objective We evaluated the usefulness of LOH/MSI as a diagnostic/prognostic biomarker in lesions derived from thyroid follicular cells: follicular thyroid carcinoma (FTC); follicular adenoma (FA), papillary thyroid carcinoma (PTC), and nodular goiter (NG). Methods We performed allelotyping (GeneMapper Software v. 4.0.) of ten microsatellite markers linked to the 1p31.2, 3p21.3, 3p24.2, 9p21.3, 11p15.5, and 16q22.1 region on DNA from 93 primary thyroid lesions then evaluated the LOH/MSI frequency and overall frequency of allelic loss (OFAL). Results We found regions with significantly increased frequency of LOH/MSI for specific histotypes: the 3p24.2 region for FA and 1p31.2 for FTC. LOH/MSI in 3p21.3 was significantly elevated in PTC and FTC. LOH/MSI in 3p21.3 was increased for small size tumors (T1a + T1b), tumors with no regional lymph node involvement (N0 + Nx), American Joint Committee on Cancer (AJCC) stage I tumors, and tumor diameter (Td) < 10 mm; in 1p31.2 for T2–3, N1, stage II–IV, and Td 10–30 mm; in 11p15.5 for T2–3, N1, stage II–IV, and Td > 30 mm. OFAL values were significantly higher in younger patients (< 40 years), in men, in those with T2–3 stage tumors, in those with increased Td, and in FA and FTC compared with NG and PTC. Conclusions We confirmed the occurrence of LOH/MSI in 3p21.3 at an early stage of tumorigenesis and mapped 1p31.2 and 11p15.5 as characteristic for advanced-stage tumors. The results of our study may enable consideration of OFAL, defined as LOH/MSI coincidence in various chromosomal regions, as a tumor progression marker. OFAL values were significantly higher in follicular neoplasms (FA and FTC) than in PTC or NG; hence, increased OFAL values can be regarded as a characteristic feature of the follicular phenotype.
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Genutis LK, Tomsic J, Bundschuh RA, Brock PL, Williams MD, Roychowdhury S, Reeser JW, Frankel WL, Alsomali M, Routbort MJ, Broaddus RR, Wakely PE, Phay JE, Walker CJ, de la Chapelle A. Microsatellite Instability Occurs in a Subset of Follicular Thyroid Cancers. Thyroid 2019; 29:523-529. [PMID: 30747051 PMCID: PMC6457885 DOI: 10.1089/thy.2018.0655] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Inactivation of DNA mismatch repair (MMR) and the resulting microsatellite instability (MSI) are frequently observed in endometrial, stomach, and colorectal cancers, as well as more rarely in other solid tumor types. The prevalence of MSI in thyroid cancer has not been explored in depth, although recent studies utilizing data from large cancer sequencing efforts such as The Cancer Genome Atlas indicate that MSI is absent or at least very rare in the most common and most well studied histologic subtype, papillary thyroid carcinoma. This study aimed to determine the prevalence of MSI in thyroid cancer by using a large series comprising all major histological subtypes. METHODS A total of 485 thyroid cancer patients were screened for MSI/MMR deficiency, including all major histologic subtypes (195 papillary thyroid carcinoma, 156 follicular thyroid carcinoma [FTC], 50 anaplastic thyroid carcinoma, 65 medullary thyroid carcinoma, and 17 poorly differentiated thyroid carcinomas) by using a combination of polymerase chain reaction-based detection, immunohistochemistry, and next-generation sequencing. RESULTS A total of four tumors were MSI-high and had loss of MMR protein expression, all of which were from FTC patients. Whole-exome sequencing was performed on two MSI-high FTCs and revealed a hemizygous loss of function mutation in MSH2 in one tumor. CONCLUSIONS Based on these data, it is estimated that the overall prevalence of MSI in FTC is 2.5%, and MSI is either entirely absent or rare in other histology subtypes of thyroid carcinoma. These findings highlight the importance of testing for MSI in FTC.
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Affiliation(s)
- Luke K. Genutis
- Department of Cancer Biology and Genetics, The Ohio State University Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio
| | - Jerneja Tomsic
- Division of Biomarkers Early Detection Prevention, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Ralf A. Bundschuh
- Department of Physics and Department of Chemistry and Biochemistry, Division of Hematology, Department of Internal Medicine, Center for RNA Biology, The Ohio State University, Columbus, Ohio
| | - Pamela L. Brock
- Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Michelle D. Williams
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Julie W. Reeser
- Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - Wendy L. Frankel
- Department of Pathology, The Ohio State University, Columbus, Ohio
| | | | - Mark J. Routbort
- Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Russell R. Broaddus
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Paul E. Wakely
- Department of Pathology, The Ohio State University, Columbus, Ohio
| | - John E. Phay
- Department of Surgery, The Ohio State University Wexner Medical Center, The Ohio State University, Columbus, Ohio
| | - Christopher J. Walker
- Department of Cancer Biology and Genetics, The Ohio State University Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio
- Christopher J. Walker, PhD, The Ohio State University Comprehensive Cancer Center, The Ohio State University, 894 BRT, 460 W. 12th Avenue, Columbus, OH 43210
| | - Albert de la Chapelle
- Department of Cancer Biology and Genetics, The Ohio State University Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio
- Address correspondence to: Albert de la Chapelle, MD, PhD, The Ohio State University Comprehensive Cancer Center, The Ohio State University, 804 BRT, 460 W. 12th Avenue, Columbus, OH 43210
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Kim BS, Kang KH, Lim YA, Kim LS. Clinical Significance of p53, Ki-67 and Galectin-3 Expressions in Papillary Thyroid Carcinoma. J Korean Surg Soc 2009. [DOI: 10.4174/jkss.2009.77.1.29] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Byung Seup Kim
- Division of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
| | - Kyung Ho Kang
- Division of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
| | - Young Ah Lim
- Division of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
| | - Lee Su Kim
- Division of Breast and Endocrine Surgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea
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Jeong DH, Jeong JC, Park CH, Kwon MJ, Cho SJ, Nam ES, Shin HS, Kim KS. Microsatellite Instability in Invasive Ductal Carcinomas. J Breast Cancer 2007. [DOI: 10.4048/jbc.2007.10.1.77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Duck Hyoun Jeong
- Department of Surgery, Hallym University College of Medicine, Seoul, Korea
| | - Jin Cheol Jeong
- Department of Surgery, Hallym University College of Medicine, Seoul, Korea
| | - Chan Heun Park
- Department of Surgery, Hallym University College of Medicine, Seoul, Korea
| | - Mi Jung Kwon
- Department of Pathology, Hallym University College of Medicine, Seoul, Korea
| | - Seong Jin Cho
- Department of Pathology, Hallym University College of Medicine, Seoul, Korea
| | - Eun Sook Nam
- Department of Pathology, Hallym University College of Medicine, Seoul, Korea
| | - Hyung Sik Shin
- Department of Pathology, Hallym University College of Medicine, Seoul, Korea
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Abstract
Thyroid follicular tumors can be challenging diagnostically and clinically, because the cytologic and histologic features can be subtle and prognosis is also difficult to predict. In this study, we analyzed thyroid follicular tumors with known long-term follow-up for a molecular panel of tumor suppressor genes to determine whether this molecular approach has prognostic significance. Microdissection and DNA extraction were performed from tumor and normal tissue. Polymerase chain reaction (PCR) was performed for 13 short tandem repeats at or near tumor suppressor genes. PCR product was detected using semiquantitative capillary gel electrophoresis and fractional allelic loss (FAL) was calculated. We included eight adenomas, three minimally invasive carcinomas, four angioinvasive carcinomas, and three widely invasive carcinomas with a mean follow-up of 77 months. Three patients died of disease and an additional two are alive with disease recurrence/metastasis. The mean FAL for benign tumors (14%) was significantly different from that of malignant tumors (56%, p < 0.001). Patients with a follicular tumor who had no evidence of disease recurrence had a mean FAL of 22% and those with disease recurrence or death from disease had a mean of 78% (p < 0.002). Based on these results, a tumor suppressor gene panel for allelic imbalance in follicular-derived tumors (FTT) may correlate with both malignancy and outcome in patients with follicular-derived carcinomas of the thyroid.
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Affiliation(s)
- Jennifer L Hunt
- Department of Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
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Kim D, Pemberton H, Stratford AL, Buelaert K, Watkinson JC, Lopes V, Franklyn JA, McCabe CJ. Pituitary tumour transforming gene (PTTG) induces genetic instability in thyroid cells. Oncogene 2005; 24:4861-6. [PMID: 15897900 DOI: 10.1038/sj.onc.1208659] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cancer reflects the progressive accumulation of genetic alterations and subsequent genetic instability of cells. Cytogenetic studies have demonstrated the importance of aneuploidy in differentiated thyroid cancer development. The pituitary tumour transforming gene (PTTG), also known as securin, is a mitotic checkpoint protein which inhibits sister chromatid separation during mitosis. PTTG is highly expressed in many cancers and overexpression of PTTG induces aneuploidy in vitro. Using fluorescent intersimple sequence repeat PCR (FISSR-PCR), we investigated the relationship between PTTG expression and the degree of genetic instability in normal and tumorous thyroid samples. The genomic instability index (GI index) was 6.7-72.7% higher in cancers than normal thyroid tissues. Follicular thyroid tumours exhibited greater genetic instability than papillary tumours (27.6% (n=9) versus 14.5% (n=10), P=0.03). We also demonstrated a strong relationship between PTTG expression and the degree of genetic instability in thyroid cancers (R2=0.80, P=0.007). To further investigate PTTG's role in genetic instability, we transfected FTC133 thyroid follicular cells and observed increased genetic instability in cells overexpressing PTTG compared with vector-only-transfected controls (n=3, GI Index VO=29.7+/-5.2 versus PTTG=63.7+/-6.4, P=0.013). Further, we observed a dose response in genetic instability and PTTG expression (GI Index low dose (0.5 microg DNA/ six-well plate) PTTG=15.3%+/-1.7 versus high dose (3 microg DNA) PTTG=50.8%+/-3.3, P=0.006). Overall, we describe the first use of FISSR-PCR in human cancers, and demonstrate that PTTG expression correlates with genetic instability in vivo, and induces genetic instability in vitro. We conclude that PTTG may be an important gene in the mutator phenotype development in thyroid cancer.
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Affiliation(s)
- Dae Kim
- Division of Medical Sciences, 2nd Floor IBR, University of Birmingham, Edgbaston, Birmingham B12 5TT, UK.
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Abstract
The purpose of this review is to summarize current knowledge of the etiology of euthyroid and toxic multinodular goiter (MNG) with respect to the epidemiology, clinical characteristics, and molecular pathology. In reconstructing the line of events from early thyroid hyperplasia to MNG we will argue the predominant neoplastic character of nodular structures, the nature of known somatic mutations, and the importance of mutagenesis. Furthermore, we outline direct and indirect consequences of these somatic mutations for thyroid pathophysiology and summarize information concerning a possible genetic background of euthyroid goiter. Finally, we discuss uncertainties and open questions in differential diagnosis and therapy of euthyroid and toxic MNG.
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Affiliation(s)
- Knut Krohn
- Universität Leipzig, Zentrum für Innere Medizin, Medizinische Klinik und Poliklinik III, Ph.-Rosenthal-Strasse 27, 04103 Leipzig, Germany
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Abstract
The traditional view holds that hyperplasia of endocrine glands is secondary to oversecretion of a trophic hormone. However, in most cases, the mechanism underlying this growth is the spontaneous proliferation of benign neoplasias. Pathologists still depend on subtle morphological criteria to delineate and further classify these tumours. Owing to their variable architecture, a bewildering nomenclature has emerged for these tumours, exemplified by the many names applied to the goitrous thyroid gland: hyperplasia, adenomatous goitre, adenomatoid nodules, benign nodular thyroid disease, adenoma, etc. This article reviews the evidence suggesting that: (1) the varied types of benign neogeneration of endocrine tissue, the spectrum of which ranges from 'simple hyperplasia' to 'true adenoma', involve the same process; (2) even clonality of a growing lesion cannot distinguish hyperplasia from neoplasia; and (3) the basic processes in both cases are not different from those that cause benign tumours in other organs.
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Affiliation(s)
- Michael Derwahl
- Dept Medicine, St Hedwig Kliniken, and Humboldt University Berlin, Grosse Hamburger Str. 5-10, D-10115, Berlin, Germany.
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