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


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Schmitz-Winnenthal
Friedrich Hubertus
FH
Department of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
Weckauf
Heldgard
H
Haufe
Sabine
S
Hinz
Ulf
U
Z'graggen
Kaspar
K
Klar
Ernst
E
Büchler
Markus W
MW
Weber
Theresia
T
D018263:Adenocarcinoma, Follicular / Q000235:genetics / Q000378:metabolism* / Q000556:secondary; D000231:Adenocarcinoma, Papillary / Q000235:genetics / Q000378:metabolism* / Q000556:secondary; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D007381:Intermediate Filament Proteins / Q000235:genetics / Q000378:metabolism*; D053554:Keratin-20; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000473:pathology; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012333:RNA, Messenger / Q000032:analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D013965:Thyroidectomy
D014408:Biomarkers, Tumor; D007381:Intermediate Filament Proteins; C507499:KRT20 protein, human; D053554:Keratin-20; D012333:RNA, Messenger