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Abstract
In papillary thyroid carcinomas (PTCs), Ki67 labeling index (LI) is a prognosticator of metastases and recurrence, but it is not clear whether this extends to patients exposed to radiation in childhood. The aim of this work was to determine whether certain associations exist between Ki67 LI and clinicohistopathological characteristics of radiogenic and sporadic PTCs removed from patients of different ages and whether possible associations depend on the BRAFV600E status. Material and methods. Analysis of clinical histopathological and immunohistochemical (IHC) data on 552 PTCs (416 radiogenic and 136 sporadic) was performed using univariate tests and multivariate statistical modeling. Results. In radiogenic PTCs from patients aged up to 29 years, an increase in Ki67 LI was associated with the higher frequency of dominant papillary growth pattern (odds ratio (OR)=1.208, p=5.34E-04), BRAFV600E mutation (OR=1.183, p=0.007) and oncocytic changes (OR=1.120, p=0.044), and with the risk of recurrence (hazard ratio (HR)=1.249, p=0.033). An increase in Ki67 LI in the BRAFV600E-positive tumors did not lead to significant changes in pathological and clinical PTCs characteristics, whereas in the BRAFV600E-negative tumors it was associated with the risk of recurrent metastases (HR=1.227, p=0.038), including the radioiodine refractory ones (RAI-R, OR=1.551, p=0.037). The effect of Ki67 LI on the mentioned characteristics of sporadic PTC in the same age group was similar for most variables, but was absent for the risk of recurrences both in the whole group and in the BRAFV600E-positive or BRAFV600E-negative PTCs. In patients aged up to 49 years with radiogenic PTC, the effects of Ki67 LI were in line with those determined in younger patients. Conclusions. In radiogenic PTCs, unlike in sporadic tumors, an increase in Ki67 LI was associated with a worse postoperative prognosis, namely with an increase in the risk of recurrent metastases, including RAI-R, which, in turn, was associated exclusively with the BRAFV600E-negative status. In the BRAFV600E-positive PTCs, regardless of their etiology, an increase in Ki67 LI did not affect the clinical and histopathological indicators and the prognosis.
References
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