Aim To determine the prognostic value of cell cycle regulators cyclin D1
and p27 for papillary thyroid carcinomas.
Methods Analysis included 180 patients with papillary thyroid carcinoma
who underwent surgery at Split University Hospital Center between
1999 and 2001. Clinical data were obtained from clinical charts
and histopathology reports. Immunohistochemistry was performed on
formalin-fixed, paraffin-embedded tissue by antibody p27 and cyclin D1.
Quantification was based on the intensity and distribution of nuclear
staining.
Results Univariate analysis showed that sex (P = 0.019) and capsular
invasion (P = 0.010) were significant predictors of lymph node metastases,
whereas age (P = 0.96), histopathological variant (P = 0.075), size
(P = 0.556) and multifocality (P = 0.131) were not. Univariate analysis
also showed that overexpression of cyclin D1 (P < 0.001) and underexpression
of p27 (P < 0.001) predicted lymph node metastases in papillary
thyroid carcinomas. There was a significant correlation between cyclin
D1 (P = 0.024) and p27 (P = 0.029) expression in two prognostic groups
of low and high risk. Low risk group was cyclin D1 negative and p27
positive, while high risk group was cyclin D1 positive and p27 negative.
Multivariate analysis confirmed that sex (P = 0.041), capsular invasion
(P = 0.027), and p27 (P < 0.001) were strong independent predictors of
lymph node metastases in the high-risk group.
Conclusions Immunohistochemical analysis of p27 expression may be
a valuable tool for identifying risk of lymph node metastases and more
aggressive behavior of papillary thyroid carcinoma