갑상선유두암에서 p53과 Cyclin D1의 발현이 가지는 예후인자로서의 의미

Prognostic Value of p53 and Cyclin D1 in Papillary Thyroid Carcinoma

Purpose: P53 and cyclin D1 have been evaluated as a prognostic marker in papillary thyroid carcinoma (PTC). However, the relationship between p53/cyclin D1 and PTC prognosis has not yet been confirmed. Therefore, we investigated the relationship between p53/cyclin D1 and PTC prognostic factors. Methods: 919 patients with PTC were enrolled. Immunohistochemistry slides were reviewed for p53 and cyclin D1 immunoreactivity. Patients were classified into two groups according to the p53 and cyclin D1 grade: negative for ≤5% and positive for ＞5%. Medical records were reviewed to evaluate the prognostic factors, lymph node metastatic ratio (LNMR), and MACIS score. We analyzed patients based on p53/cyclin D1(−/−), p53/cyclin D1(−/＋), p53/cyclin D1(＋/−), p53/cyclin D1(＋/＋) separately for evaluation of independent effect of p53 and cyclin D1. Results: Mean age of the patients was 49.73 years (range 15∼87), and tumor size was 1.19 cm (range 0.1∼5.0). P53 was positive in 809 (88.0%) and cyclin D1 was positive in 748 (81.4%). Positivity of p53 and cyclin D1 were correlated (r=0.448). There was no statistical significance in MACIS score. Positivity of p53 and cyclin D1 were related with larger tumor size, older age, early T stage, more tumor capsulation, and female. LNMR was higher in p53/cyclin D1(＋/−) than p53/cyclin D1(−/−) (P=0.036), p53/cyclin D1(−/＋) than p53/cyclin D1(−/−) (P=0.034), and p53/cyclin D1(＋/＋) than p53/cyclin D1(−/−) (P=0.007). Conclusion: There was no consistent relationship between p53/cyclin D1 and worse prognostic factors of PTC. However, LNMR was higher in p53(＋) and cyclin D1(＋) cases independently, much more in p53/cyclin D1(＋/＋) than p53/cyclin D1(−/−).