Abstract
Objective: To investigate the invasive capability and other clinicopathological features of conventional papillary thyroid carcinoma (CVPTC) with intralobular lymphatic dissemination.Methods: Seventy-three CVPTC patients receiving total thyroidectomy were analyzed in this study. The expression of BRAF-V600E, D2-40 and CD31 in all thyroid samples was detected by immunohistochemical staining (IHC). The results were evaluated by two pathologists and were statistically analyzed. In addition, the rate of positive BRAF-V600E expression and the clinical invasiveness of CVPTC with intralobular dissemination (ID-CVPTC), multiple primary CVPTC (MP-CVPTC) and single focus CVPTC (SF-CVPTC) were evaluated. The correlation between BRAF-V600E expression, lymphatic vessel density (LVD), microvessel density (MVD) and the clinicopathological characteristics of CVPTC were assessed.Results: Twenty-five ID-CVPTC, 17 MP-CVPTC and 31 SF-CVPTC cases were included in this study. The positive expression rate of BRAF-V600E in ID-CVPTC (92.0%) was significantly higher than that in MP-CVPTC (70.6%) and SF-CVPTC (71.0%), while no significant difference in expression between MP-CVPTC and SF-CVPTC was detected (P > 0.05). The expression of BRAF-V600E was not related to clinicopathological features, including age, gender, lymph node metastasis (LNM), bilateral involvement, presence of vascular tumor thrombus, capsule invasion, nerve invasion or the maximum tumor diameter (P > 0.05). The LVD in the ID-CVPTC group (9.74 ± 2.98) was higher than that in the non-ID-CVPTC group (7.46 ± 2.5) (P < 0.05). Compared with cases without adenolobar dissemination, ID-CVPTC was associated with a younger age, higher LNM rate, and increased capsule and vessel invasiveness (P < 0.05).Conclusions: ID-CVPTC shows more aggressive features, and intralobular lymphatic dissemination may be a potential biological indicator of poor prognosis.
The Relationship between BRAF V600E Mutation and the Clinicopathological Features of the Papillary Thyroid Carcinoma
