Endocrine Abstracts

JOINT2986

Papillary thyroid carcinoma (PTC) represents the most prevalent malignancy of the thyroid gland and is generally associated with a favorable clinical trajectory. Nevertheless, a subset of cases exhibits a markedly more aggressive phenotype, often distinguished by angioinvasion and multifocality, both of which are significant prognosticators of increased locoregional invasion, heightened recurrence rates, and a greater propensity for distant metastases. These pathological features are strongly correlated with adverse clinical outcomes. Consequently, the identification of reliable molecular markers associated with angioinvasion and multifocality is paramount for refining risk stratification models and optimizing therapeutic decision-making, particularly in guiding the implementation of more extensive surgical interventions and early adjuvant radioiodine (RAI) therapy. Among the emerging molecular determinants implicated in tumor progression and neovascularization, thioredoxin (Thx) and tetraspanin 30 (CD63) have garnered significant attention. Thx, a critical modulator of redox homeostasis, has been linked to tumor proliferation, immune evasion, and metastatic dissemination, whereas CD63, a member of the tetraspanin superfamily, plays a pivotal role in tumor-endothelial interactions and vascular invasion. Given the established relationship between oxidative stress and poor prognosis in aggressive PTC variants, Thx and CD63 have emerged as promising biomarkers with potential mechanistic relevance to both angioinvasion and multifocality. This study included 20 patients diagnosed with PTC who exhibited both multifocality and angioinvasion. The reference cohort consisted of 45 patients without evidence of angioinvasion or multifocality, representing a very low-risk group following thyroidectomy. Serum levels of Thx and CD63 were quantified and analyzed for their association with aggressive histopathological features, followed by an assessment of their diagnostic performance using area under the curve (AUC) analysis. Both biomarkers were significantly elevated in patients with angioinvasive and multifocal PTC (Thx: P < 0.001, CD63: P = 0.025). Logistic regression analysis demonstrated a strong correlation between these biomarkers and aggressive tumor characteristics, supporting their potential role in vascular invasion and multifocality. Furthermore, multivariate regression confirmed their independent predictive value. Notably, a combined biomarker panel incorporating Thx and CD63 further improved the accuracy of risk stratification (AUC = 0.87), highlighting its potential clinical applicability in prognostication and personalized therapeutic decision-making for high-risk PTC cases.