TY - JOUR
T1 - Insular carcinoma
T2 - A distinct de novo entity among follicular carcinomas of the thyroid gland
AU - Pilotti, Silvana
AU - Collini, Paola
AU - Mariani, Luigi
AU - Placucci, Marco
AU - Bongarzone, Italia
AU - Vigneri, Paolo
AU - Cipriani, Sonia
AU - Falcetta, Francesca
AU - Miceli, Rosalba
AU - Pierotti, Marco A.
AU - Rilke, Franco
PY - 1997
Y1 - 1997
N2 - We reclassified 720 nonmedullary invasive thyroid carcinomas diagnosed and treated between 1975 and 1993. Twenty-seven cases met the criteria of insular carcinoma and 29 cases those of widely invasive follicular carcinoma. Comparison of these histotypes with respect to pathologic stage and overall, relative, and visceral metastasis-free survival showed a significant association between histotype and pT and pN categories. In particular, pT4 (p <0.001) and pN1 (p <0.001) categories were more frequent in the insular carcinoma histotype. By contrast, no significant differences in overall, relative, or visceral metastasis-free survival were observed between insular carcinoma and widely invasive follicular carcinoma. Molecular analysis by polymerase chain reaction-single-strand conformation polymorphism demonstrated RAS gene family point mutations in five of eight cases analyzed in each of the two histotypes, with a high proportion of CAA→AAA transversion at codon 61 of the N-RAS gene in insular carcinoma. These findings suggest that insular carcinoma represents a de novo entity distinct from widely invasive follicular carcinoma, that widely invasive follicular carcinoma has biologic characteristics more consistent with poorly differentiated than well-differentiated carcinomas, and that both insular carcinoma and widely invasive follicular carcinoma share similar molecular alterations.
AB - We reclassified 720 nonmedullary invasive thyroid carcinomas diagnosed and treated between 1975 and 1993. Twenty-seven cases met the criteria of insular carcinoma and 29 cases those of widely invasive follicular carcinoma. Comparison of these histotypes with respect to pathologic stage and overall, relative, and visceral metastasis-free survival showed a significant association between histotype and pT and pN categories. In particular, pT4 (p <0.001) and pN1 (p <0.001) categories were more frequent in the insular carcinoma histotype. By contrast, no significant differences in overall, relative, or visceral metastasis-free survival were observed between insular carcinoma and widely invasive follicular carcinoma. Molecular analysis by polymerase chain reaction-single-strand conformation polymorphism demonstrated RAS gene family point mutations in five of eight cases analyzed in each of the two histotypes, with a high proportion of CAA→AAA transversion at codon 61 of the N-RAS gene in insular carcinoma. These findings suggest that insular carcinoma represents a de novo entity distinct from widely invasive follicular carcinoma, that widely invasive follicular carcinoma has biologic characteristics more consistent with poorly differentiated than well-differentiated carcinomas, and that both insular carcinoma and widely invasive follicular carcinoma share similar molecular alterations.
KW - Insular carcinoma
KW - Molecular analysis
KW - Poorly differentiated carcinoma
KW - RAS gene family point mutations
KW - Statistical analysis
KW - Thyroid gland
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U2 - 10.1097/00000478-199712000-00009
DO - 10.1097/00000478-199712000-00009
M3 - Article
C2 - 9414190
AN - SCOPUS:0030700727
VL - 21
SP - 1466
EP - 1473
JO - American Journal of Surgical Pathology
JF - American Journal of Surgical Pathology
SN - 0147-5185
IS - 12
ER -