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Histopathologic characteristics and nuclear DNA content as prognostic factors in medullary thyroid carcinoma. A nationwide study in Sweden
Author(s) -
Bergholm Ulla,
Adami HansOlov,
Auer Gert,
Bergström Reinhold,
Bäckdahl Martin,
Grimelius Lars,
Hansson Göran,
Ljungberg Otto,
Wilander Erik
Publication year - 1989
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19890701)64:1<135::aid-cncr2820640123>3.0.co;2-g
Subject(s) - medicine , medullary cavity , nuclear dna , thyroid , thyroid carcinoma , carcinoma , medullary carcinoma , pathology , oncology , genetics , biology , mitochondrial dna , gene
Complete follow‐up for 4 to 27 years was achieved for virtually all 249 patients with medullary thyroid carcinoma (MTC) diagnosed in Sweden in a 23‐year period. Tumor specimens from 241 patients were re‐examined with regard to calcitonin immunoreactivity, amyloid content, argyrophil reaction, tumor capsule condition, and nuclear DNA content. In univariate analyses, these factors, with the exception of the argyrophil reaction, were strong predictors of survival. There were twofold‐to‐threefold differences in hazard rate between patients with a high (>50%) and low (<10%) frequency of calcitonin‐immunoreactive tumor cells, between those with amyloid‐containing and amyloid‐free tumors, and between those with an intact and a nonintact tumor capsule. Calcitonin immunoreactivity and the amyloid content also provided prognostic information in multivariate analyses that adjusted for all the other factors mentioned above and in the full multivariate model, which in addition considered age, sex, heredity, stage of the disease, tumor size, and treatment. The strong prognostic capacity of the nuclear DNA content found in univariate analyses became considerably weaker when other morphologic characteristics were considered.