Revised criteria for diagnosis of NIFTP reveals a better correlation with tumor biological behavior
| Autor: | Marcos Brasilino de Carvalho, Matheus Duarte Borges Viana, Janete M. Cerutti, Debora Mota Dias Thomaz, Paula Blandina Olga Chiappini, Gabriel Avelar Colozza-Gama, Susan C. Lindsey, Otávio Alberto Curioni, André Uchimura Bastos, Venâncio Avancini Ferreira Alves, Thais Biude Mendes, Ana Carolina de Jesus Paniza |
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| Rok vydání: | 2019 |
| Předmět: |
Neuroblastoma RAS viral oncogene homolog
Pathology medicine.medical_specialty Adenoma Endocrinology Diabetes and Metabolism 030209 endocrinology & metabolism Disease medicine.disease_cause lcsh:Diseases of the endocrine glands. Clinical endocrinology braf v600e Lesion Thyroid carcinoma 03 medical and health sciences 0302 clinical medicine Endocrinology Follicular phase Internal Medicine Medicine ras pax8-pparg Thyroid neoplasm lcsh:RC648-665 business.industry Research medicine.disease niftp 030220 oncology & carcinogenesis papillary thyroid carcinoma medicine.symptom business PAX8 |
| Zdroj: | Endocrine Connections, Vol 8, Iss 11, Pp 1529-1538 (2019) Endocrine Connections |
| ISSN: | 2049-3614 |
| DOI: | 10.1530/ec-19-0459 |
| Popis: | The recent reclassification of a follicular variant of papillary thyroid carcinoma (FVPTC), subset as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP), aims to avoid overtreatment of patients with an indolent lesion. The diagnosis of NIFTP has recently been revisited using more rigid criteria. This study presents histological and molecular findings and a long clinical follow-up of 94 FVPTC, 40 cases of follicular adenoma (FTA) and 22 cases of follicular carcinoma (FTC) that were classified before the advent of the NIFTP reclassification. All slides were reviewed using these rigid criteria and analysis of numerous sections of paraffin blocks and reclassified as 7 NIFTPs, 2 EFVPTCs, 29 infiltrative FVPTC (IFVPTCs), 57 invasive EFVPTC (I-EFVPTCs), 39 FTAs and 22 FTCs. Remarkably, EFVPTC and NIFTP patients were all free of disease at the end of follow-up and showed no BRAF mutation. Only one NIFTP sample harbored mutations, an NRAS Q61R. PAX8/PPARG fusion was found in I-EFVPTCs and FTC. Although additional studies are needed to identify a specific molecular profile to aid in the diagnosis of lesions with borderline morphological characteristics, we confirmed that the BRAF V600E mutation is an important tool to exclude the diagnosis of NIFTP. We also show that rigorous histopathological criteria should be strongly followed to avoid missing lesions in which more aggressive behavior is present, mainly via the analysis of capsule or vascular invasion and the presence of papillary structures. |
| Databáze: | OpenAIRE |
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