Defferential diagnosis and prognostic significance of squamous cell components in papillary thyroid carcinoma
10.13315/j.cnki.cjcep.2023.12.014
- VernacularTitle:甲状腺乳头状癌中鳞状细胞成分的鉴别诊断及预后意义
- Author:
Wenhao REN
1
;
Xiaozheng HUANG
;
Lixin ZHOU
;
Yanhua BAI
Author Information
1. 北京大学肿瘤医院暨北京市肿瘤防治研究所病理科/恶性肿瘤发病机制及转化研究教育部重点实验室,北京 100142
- Keywords:
papillary thyroid carcinoma;
squamous differentia-tion;
anaplastic carcinoma;
BRAF V600E;
PD-L1
- From:
Chinese Journal of Clinical and Experimental Pathology
2023;39(12):1482-1486,1491
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To investigate the diagnostic criteria and prognostic significance of squamous cell components in pa-pillary thyroid carcinoma(PTC).Methods Twenty-three cases of PTC containing squamous cell components were collect-ed,and pathological sections were reviewed.p40,CK5/6,Ki-67,BRAF V600E,p53,PD-L1(22C3),PAX8,and CD10,markers related to diagnosis,prognosis,and treatment,were de-tected by immunohistochemistry.Histological characteristics and immunophenotype of squamous cell components were comprehen-sively evaluated.The squamous cell components were classified histologically.The relationship between squamous cell classifica-tion and clinicopathological parameters,and their prognostic im-pact were analyzed.Results The squamous cell components were divided into squamous differentiation(19 cases)and ana-plastic carcinoma(4 cases).In the latter,the squamous cell components were diffusely distributed in sheets;the cell atypia was moderate to severe;and the Ki-67 index was at least 30%.High expression of p53 was found only in anaplastic carcinoma.Compared with squamous differentiation,anaplastic carcinoma had a larger diameter,higher BRAF V600E positive rate,high PD-L1 combined positive score,and extremely worse progression-free survival and overall survival.Squamous differentiation had inconspicuous impact on survival,and only one case relapsed af-ter secondary surgery.Conclusion The cell atypia,distribu-tion,maximum diameter,Ki-67 and p53 expression of squamous cell components are helpful in differentiating squamous compo-nents from anaplastic carcinoma.Positive BRAF V600E and PD-L1 expression suggest the feasibility of targeted therapy and im-munotherapy for anaplastic carcinoma.
