Skip to main content
SpringerLink
Log in

Detection of lymph node metastases of papillary thyroid cancer—comparison of the results of histopathology, immunohistochemistry and reverse transcription-polymerase chain reaction—a preliminary report

  • Original Article
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Background

The range of lymphadenectomy in differentiated thyroid cancer remains still a matter of controversy because of the lack of reliable diagnostic methods for nodal metastases, other than histopathology.

Aim

To compare the results of detection of lymph node metastases of papillary thyroid cancer by conventional histopathology and immunohistochemistry with the results of reverse transcription–polymerase chain reaction for thyroglobulin mRNA.

Patients and methods

Each of 166 cervical lymph nodes obtained from 21 patients was divided into two halves: one was used for conventional histopathology and immunohistochemistry, the other part was investigated by molecular examination.

Results

We obtained different results from examination of the lymph nodes in six (28.6%) patients. In four patients (19.1%) reverse transcription–polymerase chain reaction (RT-PCR) was more sensitive in detection of positive lymph nodes; in two patients (9.5%) it revealed fewer metastasised lymph nodes than did histopathology. The rest of the patients did not have any differences: 12 (57.1%) of them had negative lymph nodes and three (14.3%) had positive lymph nodes in all examinations.

Conclusions

(1) Thyroglobulin (Tg) RT-PCR is an appropriate method of detection for thyroid cancer cells. (2) In combination with histopathology, it might help to qualify patients’ nodal status better.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bramsley MD, Harrison BJ (1996) Papillary microcarcinoma of the thyroid gland. Br J Surg 83:1674–1683

    PubMed  Google Scholar 

  2. Noguchi S, Yamashita H, Murakami N, Nakayama I, Toda M, Kawamoto H (1996) Small carcinomas of the thyroid. Arch Surg 131:187–191

    CAS  PubMed  Google Scholar 

  3. Gagel RF, Goepfert H, Callender DL (1996) Changing concepts in the pathogenesis and management of thyroid carcinoma. CA Cancer J Clin 46:261–283

    CAS  PubMed  Google Scholar 

  4. Pasieka LJ, Zedenius J, Auer G, Grimelius L, Höög A, Lundell G, Wallin G, Bäckdahl M (1992) Addition of nuclear DNA content to the AMES risk-group classification for papillary thyroid cancer. Surgery 112:1154–1160

    CAS  PubMed  Google Scholar 

  5. Sanders LE, Cady B (1998) Differentiated thyroid cancer. Arch Surg 133:419–425

    CAS  PubMed  Google Scholar 

  6. Herman K, Wysocki W, Fortuna J (2001) Should neck lymph nodes be electively removed in differentiated thyroid carcinoma (in Polish). Wiad Lek 54 [Suppl 1]:204–209

    Google Scholar 

  7. Bhattacharyya N (2003) A population-based analysis of survival factors in differentiated and medullary thyroid carcinoma. Otolaryngol Head Neck Surg 128:115–123

    PubMed  Google Scholar 

  8. Steinmuller T, Klupp J, Rayes N, Ulrich F, Jonas S, Graf KJ, Neuhaus P (2000) Prognostic factors in patients with differentiated thyroid carcinoma. Eur J Surg 166:29–33

    CAS  PubMed  Google Scholar 

  9. Ward LS, Souza SL (2003) The impact of nodal metastases on prognosis of well-differentiated thyroid cancer suggests the practice of prophylactic neck dissection. Arch Otolaryngol Head Neck Surg 129:495–496

    PubMed  Google Scholar 

  10. Jarząb B (1995) Treatment of thyroid cancer (in Polish). Pol J Endocrinol 46 [Suppl 1]:25–35

    Google Scholar 

  11. Cady B, Rossi R (1988) An expanded view of risk-group definition in differentiated thyroid carcinoma. Surgery 104:947–953

    CAS  PubMed  Google Scholar 

  12. Rossi R, Cady B, Silverman M, Wood MS, Horner T (1986) Current results of conservative surgery for differentiated thyroid carcinoma. World J Surg 10:621–622

    Google Scholar 

  13. Dralle H, Gimm O (1996) Lymph node in thyroid carcinoma (in German). Chirurg 67:788–806

    CAS  PubMed  Google Scholar 

  14. Beasley NJ, Lee J, Eski S, Walfish P, Witterick I, Freeman JL (2002) Impact of nodal metastases on prognosis in patients with well-differentiated thyroid cancer. Arch Otolaryngol Head Neck Surg 128:825–828

    PubMed  Google Scholar 

  15. McHenry CR, Rosen IB, Walfish PG (1991) Prospective management of nodal metastases in differentiated thyroid cancer. Am J Surg 162:353–356

    CAS  PubMed  Google Scholar 

  16. Noguchi S, Murakami N (1987) The value of lymph-node dissection in patients with differentiated thyroid cancer. Surg Clin North Am 67:251–261

    CAS  PubMed  Google Scholar 

  17. Mussacchio MJ, Kim AW, Vijungco JD, Prinz RA (2003) Greater local recurrence occurs with berry picking than neck dissection in thyroid cancer. Am Surgeon 69:191–197

    PubMed  Google Scholar 

  18. Sivanandan R, Soo KC (2001) Pattern of cervical lymph node metastases from papillary carcinoma of the thyroid. Br J Surg 88:1241–1244

    CAS  PubMed  Google Scholar 

  19. Kobayashi T, Asakawa H, Komoike Y, Tamaki Y, Monden M (1999) Characteristics and prognostic factors in patients with differentiated thyroid cancer who underwent a total or subtotal thyroidectomy: surgical approach for high-risk patients. Surg Today 29:200–203

    CAS  PubMed  Google Scholar 

  20. Noguchi S, Murakami N, Yamashita H, Toda M, Kawamoto H (1998) Papillary thyroid carcinoma: modified radical neck dissection improves prognosis. Arch Surg 133:276–280

    CAS  PubMed  Google Scholar 

  21. Weber T, Amann K, Weckauf H, Lacroix J (2002) Detection of disseminated medullary thyroid carcinoma cells in cervical lymph nodes by cytokeratin 20 reverse transcription–polymerase chain reaction. World J Surg 26:148–152

    PubMed  Google Scholar 

  22. Witte J, Goretzki PE, Dicken J, Simon D, Roher HD (2002) Importance of lymph node metastases in follicular thyroid cancer. World J Surg 26:1017–1022

    PubMed  Google Scholar 

  23. Pomorski L (2001) Operations of cervical lymph nodes in patients with differentiated thyroid cancer: selective or elective lymphadenectomy (in Polish). Wiad Lek 54 [Suppl 1]:198–204

    PubMed  Google Scholar 

  24. Suwiński R, Gawkowska-Suwińska M (2001) Radiobiology of radioiodine treatment for thyroid cancer. Wiad Lek 54 [Suppl 1]:266–277

    PubMed  Google Scholar 

  25. Wheldon TE, O’Donoghue JA (1990) The radiobiology of targeted radiotherapy. Int J Radiat Biol 58:1–28

    Google Scholar 

  26. Robbins KT, Medim JE, Wolfe GT, Levine PA, Sessions RR (1991) Standardizing neck dissection terminology. Arch Otolaryngol Head Neck Surg 117:601–605

    CAS  PubMed  Google Scholar 

  27. Szawłowski AW, Szmidt J (2003) The rules of diagnosis and surgical treatment of neoplasms in Poland (in Polish). Foundation—The Polish Journal of Surgery, Warsaw, Poland

    Google Scholar 

  28. Pomorski L, Cywiński J, Kołomecki K, Pasieka Z, Bartos M, Kuzdak K (2003) Recurrences of thyroid cancer after radical surgery and complementary treatment: are macroscopic, microscopic, scintigraphic and biochemical criteria sufficient in the evaluation of radicality of primary treatment? Recent Results Cancer Res 162:203–207

    PubMed  Google Scholar 

  29. Machens A, Holzhausen HJ, Dralle H (2004) Skip metastases in thyroid cancer leaping the central lymph node compartment. Arch Surg 139:43–45

    PubMed  Google Scholar 

  30. Ducci M, Appetecchia M, Marzetti M (1997) Neck dissection for surgical treatment of lymph node metastasis in papillary thyroid carcinoma. J Exp Clin Cancer Res 16:333–335

    CAS  PubMed  Google Scholar 

  31. Coatesworth AP, MacLennan K (2002) Cervical metastasis in papillary carcinoma of the thyroid: a histopathological study. Int J Clin Pract 56:241

    CAS  PubMed  Google Scholar 

  32. Pingpank JF, Sasson AR, Hanlon AL, Friedman CD, Ridge JA (2002) Tumor above the spinal accessory nerve in papillary thyroid cancer that involves lateral neck nodes: a common occurrence. Arch Otolaryngol Head Neck Surg 128:1275–1278

    PubMed  Google Scholar 

  33. Burt A, Goudie RB (1979) Diagnosis of primary thyroid carcinoma by immunohistological demonstration of thyroglobulin. Histopathology 3:279–286

    CAS  PubMed  Google Scholar 

  34. Pisani T, Vecchione A, Sinopoli NT, Drusco A, Valli C, Giovagnoli MR (1999) Cytological and immunohistochemical analysis of laterocervical lymph nodes in patients with previous thyroid carcinoma. Anticancer Res 19:3527–3530

    CAS  PubMed  Google Scholar 

  35. Pisani T, Caponetti R, Drusco A, Mottolese M, Intrieri FS, Giovagnoli MR (1997) Value of immunohistochemistry in the diagnosis of laterocervical masses in patients with a previous history of thyroid carcinoma (in Italian). Minerva Endocrinol 22:99–102

    CAS  PubMed  Google Scholar 

  36. Liefers GJ, Cleton-Jansen AM, van de Velde CJ, Hermans J, van Krieken JH, Tollenar RA (1998) Micrometastases and survival in stage II colorectal cancer. N Engl J Med 339:223–228

    Article  CAS  PubMed  Google Scholar 

  37. Weitz J, Kienle P, Lacroix J, Willeke F, Benner A, Lehnert T (1998) Dissemination of tumor cells in patients undergoing surgery for colorectal cancer. Clin Cancer Res 4:343–348

    CAS  PubMed  Google Scholar 

  38. Weitz J, Kienle P, Magener A, Koch M (1999) Detection of disseminated colorectal cancer cells in lymph nodes, blood and bone marrow. Clin Cancer Res 5:1830–1836

    CAS  PubMed  Google Scholar 

  39. Futamura M, Takagi Y, Koumura H, Kida H, Tanemura H (1998) Spread of colorectal cancer micrometastases in regional lymph nodes by reactions for carcinoembryonic antigen and cytokeratin 20. J Surg Oncol 68:34–40

    Article  CAS  PubMed  Google Scholar 

  40. Gunn J, McCall JL, Yun K, Wright PA (1996) Detection of micrometastases in colorectal cancer patients by K19 and K20 reverse-transcription polymerase chain reaction. Lab Invest 75:611–616

    CAS  PubMed  Google Scholar 

  41. Lukyanchuk VV, Friess H, Kleff J, Osinky SP, Ayuni E, Candinas D, Roggo A (2003) Detection of circulating tumor cells by cytokeratin 20 and prostate stem cell antigen RT-PCR in blood of patients with gastrointestinal cancers. Anticancer Res 23:2711–2716

    PubMed  Google Scholar 

  42. Peley G, Toth J, Csuka, Sinkovics I, Farkas E, Koves I (2001) Immunohistochemistry and reverse transcriptase polymerase chain reaction on sentinel lymph nodes can improve the accuracy of nodal staging in breast cancer patients. Int J Biol Markers 16:227–232

    CAS  PubMed  Google Scholar 

  43. Wascher RA, Bostick PJ, Huynh KT, Turner R, Qi K, Giuliano AE (2001) Detection of MAGE-A3 in breast cancer patients’ sentinel lymph nodes. Br J Cancer 85:1340–1346

    CAS  PubMed  Google Scholar 

  44. Deguchi T, Doi T, Ehara H, Takahashi Y, Nishino Y, Fujihiro S, Kawamura T, Komeda H, Horie M, Kaji H, Shimokawa K, Tanaka T, Kawada Y (1993) Detection of micrometastatic prostate cancer in lymph nodes by reverse transcriptase–polymerase chain reaction. Cancer Res 53:5350–5354

    CAS  PubMed  Google Scholar 

  45. Weber T, Klar E (2001) Minimal residual disease in thyroid carcinoma. Semin Surg Oncol 20:272–277

    CAS  PubMed  Google Scholar 

  46. Bojunga J, Röddiger S, Stanisch M, Kusterer K, Kurek R (2000) Molecular detection of thyroglobulin mRNA transcripts in peripheral blood of patients with thyroid disease by RT-PCR. Br J Cancer 82:1650–1655

    CAS  PubMed  Google Scholar 

  47. Aust G, Crisp M, Bosenberg E, Ludgate M, Weetman AP, Paschke R (1998) Transcription of thyroid autoantigens in non-expressing tissues. Exp Clin Endocrinol Diabetes 106:319–323

    Google Scholar 

  48. Tallini G, Ghossein RA, Emanuel J, Gill J, Kinder B, Dimich AB, Costa J, Robbins R, Burrow GN, Rosai J (1998) Detection of thyroglobulin, thyroid peroxidase and RET/PTC1 mRNA transcripts in the peripheral blood of patients with thyroid disease. J Clin Oncol 16:1158–1166

    CAS  PubMed  Google Scholar 

  49. International Union Against Cancer (2002) TNM classification of malignant tumours, 6th edn. Wiley–Liss, New York, pp 52–56

    Google Scholar 

Download references

Acknowledgements

This work was supported by grant 503-11-016 Medical University, Łódź, Poland.

Author information

Authors and Affiliations

  1. Department of Endocrinological and General Surgery, Medical University of Lodz, Pabianicka 62, 93-513, Lodz, Poland

    L. Pomorski, Krzysztof Kaczka & K. Kuzdak

  2. Department of Molecular Pathology and Neuropathology, Medical University, Lodz, Poland

    S. Piaskowski, I. Wójcik & P. Rieske

  3. Department of Pathomorphology, The Memorial Copernicus Hospital, Lodz, Poland

    M. Matejkowska

Authors
  1. L. Pomorski
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Krzysztof Kaczka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. S. Piaskowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. I. Wójcik
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. P. Rieske
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. Matejkowska
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. K. Kuzdak
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Krzysztof Kaczka.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pomorski, L., Kaczka, K., Piaskowski, S. et al. Detection of lymph node metastases of papillary thyroid cancer—comparison of the results of histopathology, immunohistochemistry and reverse transcription-polymerase chain reaction—a preliminary report. Langenbecks Arch Surg 390, 209–215 (2005). https://doi.org/10.1007/s00423-004-0528-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-004-0528-1

Keywords

Search

Navigation