유두상 갑상선암종의 종양맥관형성도와 상피분화도

Abstract

PURPOSE: This study was carried out to investigate the correlation among tumor angiogenetic activity, epithelial membrane antigen (EMA) reactivity and various clinicopathologic parameters. We also evaluated the validity of both as an independent prognostic factor in patients with papillary thyroid carcinoma. MATERIALS & METHODS: We studied 120 patients out of 727 patients with papillary thyroid casrcinoma who underwent thyroidectomy at our institute from January 1986 to December 1994. The age of the patients ranged from 14 to 80 years with a mean of 48.2 years. There were 24 males and 96 females (M:F=1:4). The paraffin embedded tissues of these patients were stained with the monoclonal antibodies against factor VIII related antigen, antigen CD34 to highlight microvessels and against EMA to show immunoreactivity. We measured microvessel density (MVD) in the area of highest vascular density at 200 times of magnification (0.785 mm2 per field). The positive cells for EMA were counted as percentages of the whole cell population and the degree of reaction was rated on a five-point scale. RESULTS: Mean MVDs and EMA reactivities by location of tissue per field were 64.8+/-18.9, 1.97+/-0.74, in the center of the tumor; 41.3+/-15.3, 1.55+/-0.68 in the periphery of tumor; and 22.1+/-14.4, 1.09+/-0.75 in normal thyroid tissue, respectively. In relation to TNM stage, only the MVDs of patients with stage IV disease were higher than those of other disease stages with statistical significance (p<.05). In relation to DeGroot stage, the MVDs of patients with stage IV disease was also higher than others with statistical significance (p<.005). There were no significant differences in MVD and EMA reactivity between the two groups of low risk (n=77) and high risk (n=43) by AMES scale. The MVDs and EMA reactivities of patients with local recurrence (n=23) and death (n=7) during the follow-up period had no statistical significance against those patients without recurrence and living patients. CONCLUSION: Tumor angiogenic activity and EMA reactivity in papillary thyroid carcinoma did not correlate with TNM stage, DeGroot stage, AMES score, local recurrence, and patient death. However, MVD was significantly higher in patients with distant metastasis and may be useful in predicting the distant metastasis in papillary thyroid carcinoma.