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

Research output: Contribution to journalArticlepeer-review


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
Issue number1
Publication statusPublished - 1994


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

ASJC Scopus subject areas

  • Cancer Research
  • Oncology


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