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Overexpression of Cyclin D1 and Underexpression of p27 Predict Lymph Node Metastases in Papillary Thyroid Carcinoma

Department of Pathology, University Health Network (M.L.C.K., S.L.A.); Departments of Otolaryngology (M.L.C.K., N.J.P.B., J.L.F.) and Medicine (Endocrinology) (S.E.), Mount Sinai Hospital; and Departments of Laboratory Medicine and Pathobiology (S.L.A.), Otolaryngology (J.L.F.), and Medicine (S.E.), University of Toronto, Toronto, Ontario, Canada M5G 2M9

Address all correspondence and requests for reprints to: Sylvia L. Asa, M.D., Ph.D., Department of Pathology, University Health Network, 610 University Avenue, Suite 4-302, Toronto, Ontario M5G 2 M9 Canada. E-mail: . sylvia.asa{at}uhn.on.ca

Abstract

Lymph node metastasis in papillary thyroid carcinoma increases the morbidity of treatment and the risk of local regional relapse and may also affect cure rates and survival. Factors that predict lymph node metastasis are, however, unclear. We analyzed 125 patients with papillary thyroid carcinoma for factors that predict lymph node metastasis. On univariate analysis, age, extrathyroidal extension, tumor focality, overexpression of cyclin D1, and underexpression of p27 predicted lymph node metastasis, whereas patient gender and tumor size did not. On multivariate analysis, extrathyroidal extension, overexpression of cyclin D1, and underexpression of p27 proved to be strong independent predictors of lymph node metastasis. We suggest that immunohistochemistry for cyclin D1 and p27 will prove valuable in identifying papillary thyroid carcinomas with metastatic potential.

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