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Article: Insular and anaplastic carcinoma of the thyroid: A 45-year comparative study at a single institution and a review of the significance of p53 and p21

TitleInsular and anaplastic carcinoma of the thyroid: A 45-year comparative study at a single institution and a review of the significance of p53 and p21
Authors
Issue Date2000
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.com
Citation
Annals Of Surgery, 2000, v. 231 n. 3, p. 329-338 How to Cite?
AbstractObjective: To analyze the clinicopathologic features of a large cohort of patients with insular or anaplastic carcinomas treated at a single institution. Summary Background Data: Insular and anaplastic carcinomas of the thyroid, although uncommon, have more aggressive clinical behavior than well-differentiated carcinomas of the thyroid. In the literature, the incidence and features of these carcinomas have not been fully characterized. Methods: The authors reclassified 740 primary thyroid carcinomas diagnosed and treated between January 1, 1954, and December 30, 1998, to select those with features that met the histologic criteria of insular or anaplastic carcinoma. The clinicopathologic features of these carcinomas were studied and compared. The expression of p53 and p21 in these tumors was analyzed by immunohistochemistry. Results: Twenty-two patients (5 men, 17 women) with insular carcinoma and 38 patients (7 men, 31 women) with anaplastic carcinoma were found. Patients with insular carcinomas were younger (mean age 45 vs. 70 years) and had smaller tumors than those with anaplastic carcinomas (mean diameter 5 vs. 8 cm). Insular carcinomas were commonly mislabeled as other histologic subtypes, whereas anaplastic carcinomas might be overdiagnosed on pathologic examination. A history of longstanding goiter (> 10 years) was noted in 27% of patients with insular carcinoma and 24% of patients with anaplastic carcinomas. Concomitant well-differentiated carcinomas of the thyroid were noted in 59% of patients with insular carcinoma and 39% of patients with anaplastic carcinoma. In anaplastic carcinomas, 13% of patients had concomitant insular carcinoma. Calcification or bone was noted in the stroma of 23% of patients with insular carcinomas and 47% of those with anaplastic carcinomas. The 10-year survival rates for patients with insular carcinoma and anaplastic carcinoma were 42% and 3%, respectively. Distant metastases were seen in 32% of patients with insular carcinoma and in 47% of patients with anaplastic carcinomas. In both types of carcinomas, metastatic tumors were often seen in bone and lung. Distant metastases were noted in a variety of organs in anaplastic carcinomas. In insular carcinoma, neither p53 nor p21 expression was present. In anaplastic carcinoma, p53 and p21 expression was identified in 69% and 3%, respectively. Concomitant expression of p53 and p21 was noted in one tumor. Conclusions: Insular carcinoma and anaplastic carcinoma had distinctive clinicopathologic features, and recognition of these histologiC variants is important for better management of these tumors in the future, p53 overexpression might have a role in dedifferentiation from insular carcinoma to anaplastic carcinoma.
Persistent Identifierhttp://hdl.handle.net/10722/49418
ISSN
2015 Impact Factor: 8.569
2015 SCImago Journal Rankings: 4.503
PubMed Central ID
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLam, KYen_HK
dc.contributor.authorLo, CYen_HK
dc.contributor.authorChan, KWen_HK
dc.contributor.authorWan, KYen_HK
dc.date.accessioned2008-06-12T06:42:04Z-
dc.date.available2008-06-12T06:42:04Z-
dc.date.issued2000en_HK
dc.identifier.citationAnnals Of Surgery, 2000, v. 231 n. 3, p. 329-338en_HK
dc.identifier.issn0003-4932en_HK
dc.identifier.urihttp://hdl.handle.net/10722/49418-
dc.description.abstractObjective: To analyze the clinicopathologic features of a large cohort of patients with insular or anaplastic carcinomas treated at a single institution. Summary Background Data: Insular and anaplastic carcinomas of the thyroid, although uncommon, have more aggressive clinical behavior than well-differentiated carcinomas of the thyroid. In the literature, the incidence and features of these carcinomas have not been fully characterized. Methods: The authors reclassified 740 primary thyroid carcinomas diagnosed and treated between January 1, 1954, and December 30, 1998, to select those with features that met the histologic criteria of insular or anaplastic carcinoma. The clinicopathologic features of these carcinomas were studied and compared. The expression of p53 and p21 in these tumors was analyzed by immunohistochemistry. Results: Twenty-two patients (5 men, 17 women) with insular carcinoma and 38 patients (7 men, 31 women) with anaplastic carcinoma were found. Patients with insular carcinomas were younger (mean age 45 vs. 70 years) and had smaller tumors than those with anaplastic carcinomas (mean diameter 5 vs. 8 cm). Insular carcinomas were commonly mislabeled as other histologic subtypes, whereas anaplastic carcinomas might be overdiagnosed on pathologic examination. A history of longstanding goiter (> 10 years) was noted in 27% of patients with insular carcinoma and 24% of patients with anaplastic carcinomas. Concomitant well-differentiated carcinomas of the thyroid were noted in 59% of patients with insular carcinoma and 39% of patients with anaplastic carcinoma. In anaplastic carcinomas, 13% of patients had concomitant insular carcinoma. Calcification or bone was noted in the stroma of 23% of patients with insular carcinomas and 47% of those with anaplastic carcinomas. The 10-year survival rates for patients with insular carcinoma and anaplastic carcinoma were 42% and 3%, respectively. Distant metastases were seen in 32% of patients with insular carcinoma and in 47% of patients with anaplastic carcinomas. In both types of carcinomas, metastatic tumors were often seen in bone and lung. Distant metastases were noted in a variety of organs in anaplastic carcinomas. In insular carcinoma, neither p53 nor p21 expression was present. In anaplastic carcinoma, p53 and p21 expression was identified in 69% and 3%, respectively. Concomitant expression of p53 and p21 was noted in one tumor. Conclusions: Insular carcinoma and anaplastic carcinoma had distinctive clinicopathologic features, and recognition of these histologiC variants is important for better management of these tumors in the future, p53 overexpression might have a role in dedifferentiation from insular carcinoma to anaplastic carcinoma.en_HK
dc.format.extent388 bytes-
dc.format.mimetypetext/html-
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.annalsofsurgery.comen_HK
dc.relation.ispartofAnnals of Surgeryen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshCarcinoma - metabolism - mortality - pathologyen_HK
dc.subject.meshCyclins - metabolismen_HK
dc.subject.meshThyroid Neoplasms - metabolism - mortality - pathologyen_HK
dc.subject.meshTumor Markers, Biological - metabolismen_HK
dc.subject.meshTumor Suppressor Protein p53 - metabolismen_HK
dc.titleInsular and anaplastic carcinoma of the thyroid: A 45-year comparative study at a single institution and a review of the significance of p53 and p21en_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0003-4932&volume=231&issue=3&spage=329&epage=338&date=2000&atitle=Insular+and+anaplastic+carcinoma+of+the+thyroid:+a+45-year+comparative+study+at+a+single+institution+and+a+review+of+the+significance+of+p53+and+p21en_HK
dc.identifier.emailChan, KW:hrmtckw@hku.hken_HK
dc.identifier.authorityChan, KW=rp00330en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1097/00000658-200003000-00005en_HK
dc.identifier.pmid10714625-
dc.identifier.pmcidPMC1421003en_HK
dc.identifier.scopuseid_2-s2.0-0034011887en_HK
dc.identifier.hkuros53211-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0034011887&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume231en_HK
dc.identifier.issue3en_HK
dc.identifier.spage329en_HK
dc.identifier.epage338en_HK
dc.identifier.isiWOS:000085635500005-
dc.publisher.placeUnited Statesen_HK

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