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Clinical Utility of KAP-1 Expression in Thyroid Lesions

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Abstract

Although there are evidences of the involvement of KAP-1 in other tumors, data on differentiated thyroid carcinomas (DTC) are still lacking. We aimed to evaluate KAP-1 clinical utility in the diagnosis and prognosis of DTC. We used both visual immunohistochemistry and a semiquantitative analysis to evaluate KAP-1 expression in 230 thyroid carcinomas and 131 noncancerous thyroid nodules. There were 43 follicular carcinomas (FC) and 187 papillary thyroid carcinomas (PTC), including 130 classic (CPTC), 4 tall cells (TCPTC), and 53 follicular variants (FVPTC). Patients were followed up for 53.8 ± 41 months. They were classified as free-of-disease (142 cases) or poor outcome (25 cases—10 deaths), according to their serum Tg levels and image evidences. KAP-1 was identified in 78 % PTC, 75 % TCPTC, 74 % FC, 72 % FVPTC, 55 % FA, 44 % hyperplasia, and 11 % normal thyroid tissues. A ROC analysis identified malignant nodules with 69 % sensitivity and 75 % specificity, using a cutoff of 73.19. In addition to distinguishing benign from malignant thyroid tissues (p < 0.0001), KAP-1 expression differentiated CPTC from nodular hyperplasia (p < 0.0001), CPTC from FA (p = 0.0028), FVPTC from hyperplasia (p = 0.0039), and FC from hyperplasia (p = 0.0025). Furthermore, KAP-1 was more expressed in larger tumors (>4 cm; p = 0.0038) and in individuals who presented recurrences/metastases (p = 0.0130). We suggest that KAP-1 may help diagnose thyroid nodules, characterize follicular-patterned thyroid lesions, and identify individuals with poor prognosis.

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Acknowledgments

We thank the State of São Paulo Research Foundation (Fapesp) for supporting this study.

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Authors and Affiliations

  1. Laboratory of Cancer Molecular Genetics, Faculty of Medical Sciences (FCM), University of Campinas (Unicamp), 126, Tessalia Vieira de Camargo St., Barão Geraldo, Campinas, 13083-970, São Paulo, Brazil

    Mariana Bonjiorno Martins, Marjory Alana Marcello, Elaine Cristina Morari, Lucas Leite Cunha & Laura Sterian Ward

  2. Department of Pathology, Hospital AC Camargo—Antonio Prudente Foundation, 211, Professor Antonio Prudente St, São Paulo, São Paulo, Brazil

    Fernando Augusto Soares

  3. Laboratory Investigative and Molecular Pathology (Ciped), Faculty of Medical Sciences (FCM), University of Campinas (Unicamp), 126, Tessália Vieira de Camargo St, Campinas, São Paulo, Brazil

    José Vassallo

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  1. Mariana Bonjiorno Martins
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  2. Marjory Alana Marcello
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  3. Elaine Cristina Morari
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  4. Lucas Leite Cunha
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  7. Laura Sterian Ward
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Correspondence to Laura Sterian Ward.

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Martins, M.B., Marcello, M.A., Morari, E.C. et al. Clinical Utility of KAP-1 Expression in Thyroid Lesions. Endocr Pathol 24, 77–82 (2013). https://doi.org/10.1007/s12022-013-9245-z

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  • DOI: https://doi.org/10.1007/s12022-013-9245-z

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