Detection and prognostic relevance of cytokeratin 20 in differentiated and anaplastic thyroid carcinomas by RT-PCR

• Published in: Surgery 2003-12, Vol.134 (6), p.964-971
• Main Authors: Schmitz-Winnenthal, Friedrich Hubertus, Weckauf, Heldgard, Haufe, Sabine, Hinz, Ulf, Z'graggen, Kaspar, Klar, Ernst, Büchler, Markus W, Weber, Theresia
• Format: Article
• Language: English
• Subjects: Adenocarcinoma, Follicular - genetics; Adenocarcinoma, Follicular - metabolism; Adenocarcinoma, Follicular - secondary; Adenocarcinoma, Papillary - genetics; Adenocarcinoma, Papillary - metabolism; Adenocarcinoma, Papillary - secondary; Biomarkers, Tumor - genetics; Biomarkers, Tumor - metabolism; Humans; Intermediate Filament Proteins - genetics; Intermediate Filament Proteins - metabolism; Keratin-20; Neoplasm Recurrence, Local - blood; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Predictive Value of Tests; Prognosis; Reverse Transcriptase Polymerase Chain Reaction; RNA, Messenger - analysis; Survival Rate; Thyroid Neoplasms - genetics; Thyroid Neoplasms - metabolism; Thyroid Neoplasms - pathology; Thyroidectomy
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/S0039-6060(03)00428-8

Metastatic disease in epithelial cancer results from tumor cell dissemination. We investigated an expression of cytokeratin 20 (CK20) by reverse transcriptase–polymerase chain reaction (RT-PCR) in differentiated (DTC) and anaplastic thyroid carcinomas (ATC) and correlated the results with TNM categories and the clinical follow-up. Tissue and blood samples of 32 patients with papillary (PTC), 17 patients with follicular (FTC), and 7 patients with ATC were obtained during operation and subjected to CK20 RT-PCR. An expression of CK20 transcripts was detected in 47% of the tissue samples of PTC, 71% of the FTC, and 14% of the ATC. Patients with CK20-positive FTC had a significantly better outcome than patients with CK20-negative FTCs (P = .0016). Disseminated tumor cells were found in 9 of 22 (41%) blood samples of patients with CK20-positive carcinomas. The detection of CK20 transcripts in peripheral blood correlated with tumor categories. Four of 8 (50%) patients with DTC and circulating tumor cells developed local or distant recurrence compared with 3 of 13 (23%) patients with CK20-positive carcinomas and CK20-negative blood samples. Our results suggest that CK20 might be a suitable differentiation marker in thyroid carcinomas. In patients with CK20-positive tumors, those with CK20-positive blood samples had a poorer prognosis. We suggest that patients with thyroid cancer with positive CK20 blood samples should be evaluated for further adjuvant therapies after surgery.