title: Intense expression of the b7-2 antigen presentation coactivator is an unfavorable prognostic indicator for differentiated thyroid carcinoma of children and adolescents.
abstract: Previous observations suggest that an immune response against thyroid carcinoma could be important for long-term survival. We recently found that infiltration of thyroid carcinoma by proliferating lymphocytes is associated with improved disease-free survival, but the factors that control lymphocytic infiltration and proliferation are largely unknown. We hypothesized that the antigen presentation coactivators (B7-1 and B7-2), which are important in other immune-mediated thyroid diseases, might be important in lymphocytic infiltration of thyroid carcinoma. To test this, we determined B7-1 and B7-2 expression by immunohistochemistry [absent (grade 0) to intense (grade 3)] in 27 papillary (PTC) and 8 follicular (FTC) thyroid carcinomas and 9 benign thyroid lesions. B7-1 and B7-2 were expressed by the majority of PTC and FTC (78% of PTC and 100% of FTC expressed B7-1; 88% of PTC and 88% of FTC expressed B7-2). B7-1 expression was more intense in PTC (1.4 +/- 0.2; P = 0.01) and FTC (2.6 +/- 0.2; P < 0.001) than in benign tumors (0.57 +/- 0.30) or presumably normal adjacent thyroid (0.07 +/- 0.07) and was more intense in carcinoma that contained lymphocytes (1.95 +/- 0.21) than in carcinoma that did not (1.08 +/- 0.26; P = 0.016). B7-2 expression was of similar intensity in benign and malignant tumors (PTC, 1.6 +/- 0.2; FTC, 2.1 +/- 0.4; benign, 1.86 +/- 0.4), but was more intense than in presumably normal adjacent thyroid (0.64 +/- 0.25; P </= 0.013). B7-2 expression also correlated with the number of tumor-associated lymphocytes per high power field (r = 0.38; P = 0.02). Recurrence developed exclusively from tumors that expressed B7-2, and intense B7-2 expression was associated with a reduced probability of remission (P = 0.04). In conclusion, these data support the hypothesis that the antigen presentation coactivators B7-1 and B7-2 may be important for lymphocytic infiltration and the immune response against thyroid carcinoma.
authors.affiliation: Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA.
authors.forename: Rima
authors.initials: R
authors.lastname: Shah
authors.forename: Kevin
authors.initials: K
authors.lastname: Banks
authors.forename: Aneeta
authors.initials: A
authors.lastname: Patel
authors.forename: Shalini
authors.initials: S
authors.lastname: Dogra
authors.forename: Richard
authors.initials: R
authors.lastname: Terrell
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Powers
authors.forename: Cydney
authors.initials: C
authors.lastname: Fenton
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Dinauer
authors.forename: R Michael
authors.initials: RM
authors.lastname: Tuttle
authors.forename: Gary L
authors.initials: GL
authors.lastname: Francis
mesh_terms: D000293:Adolescent; D015703:Antigens, CD / Q000032:analysis*; D018122:B7-1 Antigen / Q000032:analysis*; D051940:B7-2 Antigen; D002648:Child; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008562:Membrane Glycoproteins / Q000032:analysis*; D011237:Predictive Value of Tests; D011379:Prognosis; D013959:Thyroid Diseases / Q000453:epidemiology* / Q000276:immunology; D013964:Thyroid Neoplasms / Q000453:epidemiology* / Q000276:immunology*
chemical_list: D015703:Antigens, CD; D018122:B7-1 Antigen; D051940:B7-2 Antigen; C497964:CD86 protein, human; D008562:Membrane Glycoproteins