TROP-2 and 5hmC expression in follicular-patterned thyroid neoplasm emphasizing tiny well-formed papillae |
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| Institution: | 1. Department of Pathology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea;2. Department of Pathology & Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA;1. Department of Pathology, British Columbia Cancer Vancouver Centre, Vancouver, BC, Canada;2. University of British Columbia, Vancouver, BC, Canada;3. Department of Pathology, Royal Jubilee Hospital, Victoria, BC, Canada;1. Department of Pathology, Froedtert & Medical College of Wisconsin, Milwaukee, WI, USA;2. Department of Radiology, Froedtert & Medical College of Wisconsin, Milwaukee, WI, USA;3. Division of Surgical Oncology, Department of Surgery, Froedtert & Medical College of Wisconsin, Milwaukee, WI, USA;1. Department of Pathology, British Columbia Cancer Vancouver Centre, Vancouver, BC, Canada;2. University of British Columbia, Vancouver, BC, Canada;3. Department of Pathology, Royal Jubilee Hospital, Victoria, BC, Canada;1. Anatomic Pathology, Head and Neck Disease Alignment Team, City of Hope Comprehensive Cancer Center, Duarte, CA, USA;2. Department of Radiation Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA;3. Department of Neurosurgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA;4. Department of Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA |
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| Abstract: | BackgroundFollicular-patterned thyroid neoplasms (FPTNs), characterized by predominantly follicular growth pattern, represent diverse pathological entities. We aimed to study the nuclear features and the immunoexpression of trophoblast cell-surface antigen 2 (TROP-2) and 5-hydroxymethylcytosine (5hmC) in FPTNs.DesignFPTNs were divided into 4 groups: I) noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP), II) encapsulated follicular variant of papillary thyroid carcinoma (FVPTC) with capsular invasion, III) infiltrative FVPTC, and IV) PTC with a predominantly follicular pattern and well-formed papillae (<1%). Nuclear characteristics were evaluated by image analysis. TROP-2 and 5hmC immunostains were analyzed correlating with histological features using QuPath.ResultsFrom the group I to II, III, and IV, there is a gradual increase in nuclear atypia in terms of the nuclear area, max caliper, perimeter, circularity, and hematoxylin OD means (corresponding to nuclear enlargement, membrane irregularity, and clearing). A similar trend is observed in the TROP-2 expression. 5hmC expression is highly preserved in groups I, II, and III in contrast to a significant loss in group IV. Group IV tumors show more frequent regional lymph node involvement and the highest BRAF V600E mutation rate.ConclusionAmong FPTNs, group IV tumors exhibit the most advanced nuclear atypia, highest TROP-2 expression, significant 5HMC expression loss, frequent regional lymph node involvement, and the highest BRAF V600E mutation rate. Our data further support that the presence of any true papillae should be an exclusion criterion for NIFTP. Therefore, well-formed papillae even if very minute (<1% of the tumor) should not be overlooked. |
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