Prognostic value of N-myc immunoreactivity in medullary thyroid carcinoma

M. Roncalli, G. Viale, L. Grimelius, H. Johansson, E. Wilander, R. M. Alfano, D. Springall, P. M. Battezzati, J. M. Polak, G. Coggi

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Abstract

Background. The analysis of N-myc expression in some neuroendocrine tumors has been reported to provide prognostic information. To the authors' knowledge, no attempts have been made thus far to correlate N-myc expression with the clinical outcome of medullary thyroid carcinoma (MTC). Methods. N- myc gene product immunoreactivity was evaluated in 34 patients with MTC with long term follow-up, using the OA-11-803 polyclonal antiserum. The results were related to patient age and sex, sporadic or familial disease, tumor size, stage, growth rate (as determined by proliferating cell nuclear antigen [PCNA] immunostaining), and to clinical outcome. Results. Patients harboring tumors with greater than 10% neoplastic cells immunoreactive to the N-myc antiserum (58% of the cases investigated) had significantly greater tumor size (P = 0.031) than patients with fewer or no N-myc immunoreactive cells. Deregulated expression of N-myc protein in tumor cells was not due to gene amplification, as demonstrated by multiplex polymerase chain reaction (PCR). In univariate analysis, patients with more than 10% immunoreactive neoplastic cells showed a significantly shorter disease free survival than did the remaining patients (P = 0.002). Among the other clinicopathologic parameters evaluated, male sex (P = 0.039) and sporadic disease (P = 0.035) also were associated with shorter disease free survival. In multivariate analysis, N- myc immunoreactivity (P = 0.039) and male sex (p = 0.050) retained a significant correlation with poor prognosis. Conclusions. Our results suggest that immunoreactivity to the N-myc antiserum, but not tumor growth fraction as evaluated by PCNA immunostaining, is a novel and useful adjunct to predict clinical behavior of MTC.

Original languageEnglish
Pages (from-to)134-141
Number of pages8
JournalCancer
Volume74
Issue number1
DOIs
Publication statusPublished - 1994

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Keywords

  • immunocytochemistry
  • medullary thyroid carcinoma
  • multiplex polymerase chain reaction
  • N-myc
  • prognosis
  • proliferating cell nuclear antigen

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Roncalli, M., Viale, G., Grimelius, L., Johansson, H., Wilander, E., Alfano, R. M., Springall, D., Battezzati, P. M., Polak, J. M., & Coggi, G. (1994). Prognostic value of N-myc immunoreactivity in medullary thyroid carcinoma. Cancer, 74(1), 134-141. https://doi.org/10.1002/1097-0142(19940701)74:1<134::AID-CNCR2820740122>3.0.CO;2-M