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Han, Lee, Choi, Park, Lee, Kang, Ryu, Kim, Lee, Hong, Kim, Kim, Yoo, Ihm, Yoo, and Choi: The Clinical Significance of Retinoic Acid Receptor β Expressions in Primary and Recurred Metastatic Lymph Node Papillary Thyroid Carcinomas
Original Article
Journal of Korean Endocrine Society

Journal of Korean Endocrine Society 2007; 22(6): 419-427.

Published online: 20 December 2007

DOI: https://doi.org/10.3803/jkes.2007.22.6.419

The Clinical Significance of Retinoic Acid Receptor β Expressions in Primary and Recurred Metastatic Lymph Node Papillary Thyroid Carcinomas

Jae Pil Han, Seong Jin Lee, Kyung-Chan Choi1, Young-Euy Park1, Hae Ri Lee, Jun Goo Kang, Ohk Hyun Ryu, Chul Sik Kim, Byung Wan Lee, Eun Gyung Hong, Hyeon Kyu Kim, Doo-Man Kim, Jae Myung Yoo, Sung-Hee Ihm, Hyung Joon Yoo, Moon Gi Choi

Department of Internal Medicine, College of Medicine, Hallym University, Korea.

1Department of Diagnostic Pathology, College of Medicine, Hallym University, Korea.

Received 28 July 2007       Accepted 15 October 2007

Copyright © 2007 Korean Endocrine Society

Abstract

Background

The present study was designed to investigate the correlations of retinoic acid receptor β (RARβ) expression for primary and recurred metastatic lymph node (LN) papillary thyroid carcinoma (PTC) tissues and the correlations of RARβ expression with the uptake of I131 as detected on a whole body scan (WBS).

Methods

Primary and metastatic LN PTC tissues were examined by immunohistochemical methods. Staining positivity was calculated, and staining intensity was graded as negative (0), weak (1+), moderate (2+) and strong (3+). Nuclear staining intensity (NSI) of cells from tissues was also examined.

Results

Seventeen patients who had regional cervical LN metastasis without distant metastasis were included in the study, and 13 patients had the abnormal uptake of I131 as detected on a WBS. In primary PTC tissues, RARβ staining positivity and intensity of carcinoma cells were significantly higher than those of normal cells but NSI was significantly higher in normal cells than carcinoma cells. Between primary and metastatic LN PTC tissues, RARβ staining intensity was correlated after controlling for age. Primary PTC tissues from 14 (82.4%) out of 17 patients were concordant between NSI and the uptake of I131 as detected on a WBS. NSI predicted the I131 uptake as detected on a WBS with 81.3% positive predicted value (PPV) and 100% negative predicted value. Metastatic LN PTC tissues from 13 (76.5%) out of 17 patients were concordant between NSI and the uptake of I131 as detected on a WBS. NSI predicted the uptake of I131 as detected on a WBS with 76.5% PPV. When the results of NSI taken either as positive or negative were correlated with those of the uptake of I131 as detected on a WBS in primary and metastatic LN PTC tissues, the correlation was not significant after controlling for age.

Conclusion

Our results demonstrate that nuclear RARβ expression may be decreased in PTC tissues than normal thyroid tissues, and RARβ expression in primary PTC tissues as well as in recurred metastatic LN PTC tissues may predict the uptake of I131 as detected on a WBS.

Keywords: papillary thyroid carcinoma, RARβ, whole body scan

Figures and Tables

Fig. 1
Diagram of the study. Dx WBS: diagnostic I131 whole body scan; US, neck ultrasonography.
jkes-22-419-g001
Fig. 2
RARβ immunostaining. A. Normal thyroid cells in primary PTC tissues with positive RARβ staining at nucleus (brown color, ×1000). B. Carcinoma cells in primary PTC tissues with positive RARβ staining in cytoplasm as well as at nucleus (brown color, ×1000). C. Carcinoma cells in metastatic LN PTC tissues with positive RARβ staining (brown color, ×1000). Immunoperoxidase RARβ, hematoxylin counterstaining
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Table 1
Clinical characteristics of patients with PTC
jkes-22-419-i001

NT, near total thyroidectomy; T, total thyroidectomy; C, classic type; FV, follicular variant type; Tg (off), serum thyroglobulin after T4 withdrawal.

Table 2
RARβ staining positivity and intensity in primary and metastatic LN PTC tissues
jkes-22-419-i002
Table 3
Results of nuclear RARβ staining (NSI) and I131 WBS uptake in primary PTC tissues
jkes-22-419-i003
Table 4
Results of nuclear RARβ staining (NSI) and I131 WBS uptake in metastatic LN PTC tissues
jkes-22-419-i004

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