Zhou Q1, Sun J2, Yue S1, Jing J3, Yang HY3, Zheng ZG3 and Xu H1*
1Changxing County People’s Hospital, China
2Xinchang County People’s Hospital, China
3Zhejiang Cancer Hospital, China
Background: Medullary Thyroid Cancer (MTC) is a kind of rare thyroid cancer with high degree of malignancy. Although Thyroglobulin (TG) is rarely expressed in MTC, our previous studies found that there was a certain percentage of TG-positive MTC in clinical practice. We hereby aimed to explore the clinicopathological features of MTC cases with positive expression of TG. Methods: We conducted a retrospective study from June 2006 to October 2017. All the recruited cases were divided into two groups: TG-positive group and TG-negative group. Demographics, clinical profiles and pathological details were reviewed and following immunohistochemical analyses were conducted for recruited cases. Results: Of All patients included, 25 were female and 25 were male, with a medium age of 46.7 years old. The proportion of cases with a tumor mass smaller than 1 cm in diameter in the TG-positive group was significantly higher than that in the TG-negative group (46.15% [6/13] vs. 5.56% [2/36], P=0.001). The proportion of clinical stage I and stage II MTC cases in the TG-positive group was significantly higher than that in the TG-negative group (53.85% [7/13] vs. 11.11% [4/36], P=0.001). In addition, the number of patients with lymph node metastases in the TG-positive group was significantly smaller than that in the TG-negative group (P=0.016). And the TG-positive group had a lower rate of calcium salt deposition than the TG-negative group (7.14% [1/14] vs. 36.11% [13/36], P=0.045). The TG-positive groups had also lower rate of tumors with Amyloid deposits than the TG-negative group (50% [7/14] vs. 83.3% [30/36], P= 0.016). Immunohistochemical tests showed that TG-positive cells were not only limited to the follicular structures, but also expressed in nonfollicular structures such as nests, cords and sheet structures. TG-positive cells showed partially synchronous immune response to CT, CgA, Syn and CEA, which could be differentiated from mixed medullary follicular carcinoma, suggesting that TG positive cells are not the remnants of the thyroid follicular cells. MTC cells showed the ability to express TG and CT, CgA, Syn, CEA simultaneously. Conclusion: TG-positive MTC cases had significantly smaller size of tumor, lower rate of lymph node metastasis, earlier clinical stages, and better prognosis than TG-negative MTC cases in this study.
Medullary thyroid carcinoma; Thyroglobulin; CT; CEA; CgA; Syn
Zhou Q, Sun J, Yue S, Jing J, Yang HY, Zheng ZG, et al. Clinicopathological Characteristics of Medullary Thyroid Carcinoma with the Expression of Thyroglobulin in East – China. Clin Case Rep Int. 2021; 5: 1242.