title: Survival impact of psammoma body, stromal calcification, and bone formation in papillary thyroid carcinoma.
abstract: The presence of calcification is the most significant ultrasonographic finding in evaluating thyroid nodules. Calcifications are more frequently detected in papillary thyroid carcinoma than in other thyroid lesions. However, the clinical significance of calcification, including clinical correlations and impact on survival, and the molecular mechanism responsible for calcification in papillary thyroid carcinoma remain uncertain. We performed a retrospective study of patients with primary common-type papillary thyroid carcinoma to determine the clinical correlations of calcification and its impact on survival. Histologically, calcification was classified as either psammoma bodies, stromal calcification, or bone formation. They were identified in 25, 47, and 13% of all 229 cases of papillary thyroid carcinoma, respectively. The presence of psammoma bodies was significantly correlated with gross lymph node metastasis and stage grouping. Both stromal calcification and bone formation were significantly correlated with patient age. In addition, stromal calcification was associated with pT classification and gross lymph node metastasis. Papillary thyroid carcinoma with, compared to that without, psammoma bodies was associated with poorer disease-free survival. We examined the quantitative expression of BMP-1, a metalloproteinase that is reported to be involved in bone and extracellular matrix formations, and found that its expression was significantly higher in tumors with psammoma bodies or with stromal calcification (P=0.0464 and 0.0272, respectively). These results suggest that the presence of psammoma bodies is a useful predictor of outcome for patients suffering from papillary thyroid carcinoma.
authors.affiliation: Department of Pathology, Wakayama Medical University, Wakayama, Japan.
authors.forename: Yanhua
authors.initials: Y
authors.lastname: Bai
authors.forename: Gengyin
authors.initials: G
authors.lastname: Zhou
authors.forename: Misa
authors.initials: M
authors.lastname: Nakamura
authors.forename: Takashi
authors.initials: T
authors.lastname: Ozaki
authors.forename: Ichiro
authors.initials: I
authors.lastname: Mori
authors.forename: Emiko
authors.initials: E
authors.lastname: Taniguchi
authors.forename: Akira
authors.initials: A
authors.lastname: Miyauchi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ito
authors.forename: Kennichi
authors.initials: K
authors.lastname: Kakudo
mesh_terms: D000231:Adenocarcinoma, Papillary / Q000378:metabolism / Q000401:mortality* / Q000556:secondary; D014408:Biomarkers, Tumor / Q000378:metabolism; D055395:Bone Morphogenetic Protein 1 / Q000378:metabolism; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D002479:Inclusion Bodies / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D007564:Japan / Q000453:epidemiology; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D017154:Stromal Cells / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000473:pathology; D014463:Ultrasonography
chemical_list: D014408:Biomarkers, Tumor; C525705:BMP1 protein, human; D055395:Bone Morphogenetic Protein 1