title: Prevalence of RET/PTC expression in papillary thyroid carcinoma and its correlation with prognostic factors in a north Indian population.
abstract: BACKGROUND
  The prevalence of Rearranged during Transfection/Papillary Thyroid Carcinoma (RET/PTC) rearrangement in papillary thyroid carcinoma (PTC) varies in different geographic regions and its prognostic significance remains unclear.
  
  
  OBJECTIVE
  The aim of this study was to recognize the prevalence of RET/PTC expression in PTC from the endemically iodine-deficient region in Northern India and to correlate the expression with the clinicopathologic prognostic factors.
  
  
  METHODS
  Retrospective. Archival tissue used.
  
  
  METHODS
  Immunohistochemistry was performed to look for activated RET protein expression in 50 cases of PTC. No patient had any history of prior irradiation.
  
  
  METHODS
  Chi-square method, Student t test, and binary regression method. A P value of <.05 was considered significant for all the tests.
  
  
  RESULTS
  The prevalence of RET expression was 44%. Twenty-six (52%) cases showed RET immunoreactivity in histiocytes. Immunoreactivity was the highest in the classic variant of PTC (47.5%), followed by tumors with poorly differentiated areas (25%) and follicular variant (16.7%). RET expression was more prevalent in young patients (45.5 vs. 35.3%), females (43.3 vs. 40.0%), small tumors (33.3 vs. 26.7%), multicentric tumors (36.8 vs. 33.3%), tumors with extrathyroidal invasion (38.9 vs. 32.4%), and regional lymphadenopathy (55.2 vs. 22.2%), while it was less in cases with distant metastases (20 vs. 43.9%). There was no significant correlation of immunoreactivity with any prognostic factor. However, when the cases having immunoreactivity within histiocytes (n=26) and histiocytes + tumor tissue (n=28) were considered, then the expression was significantly more in cases with lymphadenopathy (P values=.009, in both instances). However, the exact clinical significance of RET/PTC positive histiocytes remained unexplained.
  
  
  CONCLUSIONS
  Prevalence of RET/PTC in our study was consistent with the reported prevalence from other geographic areas. There was no significant correlation with the clinicopathologic factors. However, uniform techniques of detection and large international collaborative studies could clear the uncertainties regarding the prognostic importance of RET/PTC.
authors.affiliation: Department of Endocrine Surgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow, India. anjali@sgpgi.in
authors.forename: A
authors.initials: A
authors.lastname: Mishra
authors.forename: V
authors.initials: V
authors.lastname: Agrawal
authors.forename: N
authors.initials: N
authors.lastname: Krishnani
authors.forename: S K
authors.initials: SK
authors.lastname: Mishra
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D002291:Carcinoma, Papillary / Q000453:epidemiology / Q000378:metabolism* / Q000473:pathology; D002648:Child; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008934:Mitogens; D009367:Neoplasm Staging; D015995:Prevalence; D011379:Prognosis; D051096:Proto-Oncogene Proteins c-ret / Q000096:biosynthesis*; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000378:metabolism* / Q000473:pathology; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D008934:Mitogens; D051096:Proto-Oncogene Proteins c-ret; C099282:RET protein, human