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Papillary Thyroid Carcinomas from Young Adults and Children Contain a Mixture of Lymphocytes

Department of Pediatrics (J.M., A.P., R.T., G.L.F.), Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814; Department of Endocrinology (R.M.T.), Memorial Sloan Kettering Cancer Center, New York, New York 10021; and Departments of Pediatrics and Clinical Investigation (G.L.F.), Walter Reed Army Medical Center, Washington, DC 20307-5001

Address all correspondence and requests for reprints to: Gary L. Francis, M.D., Ph.D., Professor, Department of Pediatrics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, Maryland 20814. E-mail: gfrancis{at}usuhs.mil.

The immune response appears to be important in preventing metastasis and recurrence of thyroid cancer. We previously showed that papillary thyroid carcinoma (PTC) from children and adolescents that contain the most numerous proliferating lymphocytes have the best prognosis. However, the types of lymphocytes involved are not yet known. To further define this, we examined 21 PTCs from patients 21 yr of age or younger (52% were 18–21 yr of age) for the presence of CD4+ (helper), CD8+ (killer), CD19+ (B cells), and CD56+ (natural killer) cells as well as proliferating lymphocytes (Ki-67+). Nearly half the PTCs contained CD4+ (9 of 21, 43%), CD8+ (8 of 21, 38%), or CD19+ (10 of 21, 48%) lymphocytes. Only one PTC (1 of 21, 5%) contained CD56+ lymphocytes, and none contained all four cell types. By dual staining, none of these lymphocytes were proliferating (Ki-67+). However, PTCs containing either CD8+ cells (n = 8) or a combination of CD4+, CD8+, and CD19+ cells (n = 5) contained more numerous proliferating lymphocytes than did PTCs containing any other combination (14.2-fold increase, P = 0.03 and 13.1-fold increase, P = 0.003, respectively). During follow-up, none of the PTCs containing either CD8+ lymphocytes or the combination of CD4+, CD8+, and CD19+ lymphocytes recurred. However, the cohort is too small and the follow-up inadequate to provide accurate information on the clinical impact of these immunological findings. We conclude that the immune response against PTC is important and also complex, involving more than one type of lymphocyte.

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or to reflect the opinions of the Uniformed Services University of the Health Sciences, the United States Army, or the Department of Defense.

Abbreviations: DAB, Diamino-benzidine; IFN, interferon-; MACIS, metastasis/age/completeness of resection/invasion/size scoring system; MHC, major histocompatibility complex; NK, natural killer; PTC, papillary thyroid carcinoma; Tg, thyroglobulin; VEGF, vascular endothelial growth factor.

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