Endocrine Abstracts

Introduction: Medullary thyroid carcinoma (MTC) and C cell hyperplasia (CCH) have a variable clinical presentation and prognosis and few data are available on the correlation between immunohistochemical characterization (IIC) and clinical behavior.

Aim: We studied the clinical and morphological characterization of CCH and MTC and we evaluated IIC expression of PTTG-1, SSTR2A, VEGFR-1, VEGFR-2 and VEGFR-3 in 23 cases of CCH and/or MTC, correlating it with clinical features

Material and methods: 23 patients, affected by CCH and/or MTC, were included from 1990 to 2010. All patients underwent total thyroidectomy, pre and post operative serum calcitonin assay, staging, histological examination with immunohistochemical evaluation of PTTG, SSTR2A, VEGFR-1, VEGFR-2 and VEGFR-3 expression and 18 of them were tested for RET mutations.

Results: After surgery 3 cases presented only CCH and 10 cases had lymph node metastases (N+) and during follow-up 7 patients (all N+) were considered uncured. PTTG and VEGFR-1 were significantly overexpressed in lympho node metastatic and uncured patients. VEGFR-2 was not much expressed in all of patients, while VEGFR-3 and STTR2A were strongly expressed in about all of patients. Four cases were familiar (2 MEN2B, 1 MEN2A and 1 FMTC).

Conclusions: Our data suggest that PTTG-1 and VEGFR-1 seem related with a poor prognosis, while the expression of VEGFR-3 and SSTR2 in all patients confirms the key role of IIC evaluation for the therapeutic approach of these patients. Finally, a more complete IIC evaluation with new markers can be useful for diagnosis, prognosis and therapy of MTC.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.