Melck A et al. (2007) Cell cycle regulators show diagnostic and prognostic utility for differentiated thyroid cancer. Ann Surg Oncol 14: 3403–3411

Patients with differentiated thyroid cancer (DTC) have a favorable prognosis; however, in some cases patients succumb to their disease because of local recurrence and/or distant metastases. There is a need to identify markers that can predict tumor behavior. A study by Melck et al. has assessed the diagnostic and prognostic utility of cell-cycle markers in DTC that have previously been implicated in other malignancies.

The expression profiles of the cell-cycle regulators p16, p21, p27, p53, p57, p63, cyclin D1, cyclin E and mdm2 were analyzed with use of tissue microarrays that contained samples from 100 benign and 105 malignant lesions and 24 lymph nodes. Compared with benign lesions, DTCs had significantly higher expression of p16 (5% vs 54.7%), p21 (38% vs 71.7%), cyclin D1 (45.7% vs 87.1%) and cyclin E (37.4% vs 72.3%; P <0.001 for all comparisons). Both malignant and benign samples showed either low-level or no staining for p57 and p63, and there were no significant differences in the expression of p27, p53, and mdm2 between the benign and malignant samples. Positive p16 staining was noted in 73% of samples from patients with lymph-node metastases, whereas only 45% of samples from patients with no lymph-node involvement stained positive for p16 (P = 0.01). Moreover, p16 immunoreactivity significantly correlated with the presence of lymph-node metastases (P = 0.03) and extrathyroidal tumor extension (P = 0.02). An inverse correlation between p27 expression and tumor multifocality was observed (P = 0.011).

This study suggests that cell-cycle regulators might be useful markers for the diagnosis and prognosis of DTC.