title: Expression of the sonic hedgehog pathway molecules in synchronous follicular adenoma and papillary carcinoma of the thyroid gland in predicting malignancy.
abstract: BACKGROUND
  Recent studies have shown that the Sonic Hedgehog pathway plays an important role in tumorigenesis and cancer proliferation. The Sonic Hedgehog pathway is required for normal thyroid gland development, but when activated as a result of gene mutation or overexpression, it may stimulate thyroid tumor cell proliferation. This study determines whether 3 molecules, Patched, Smoothened, and Sonic Hedgehog, involved in the Sonic Hedgehog pathway are overexpressed equally in synchronous follicular thyroid adenoma and papillary thyroid carcinoma.
  
  
  METHODS
  Eighteen patients with synchronous follicular thyroid adenoma and papillary thyroid carcinoma underwent thyroidectomy. Immunohistochemistry was performed on the paraffin-embedded tissue to detect expression of Patched, Smoothened, and Sonic Hedgehog in both tumor types. The expression in these neoplasms was graded by 2 observers.
  
  
  RESULTS
  Five patients had insufficient tumor tissue and were removed from the analysis. Patched expression was detected in 5 of 13 (38%) follicular adenomas and 5 of 12 (42%) papillary carcinomas. Smoothened was expressed in 4 of 13 (31%) follicular adenomas and 3 of 13 (23%) papillary carcinomas. Sonic Hedgehog was expressed in 4 of 13 (31%) follicular adenomas and 11 of 13 (85%) papillary carcinomas.
  
  
  CONCLUSIONS
  Expression of the 3 molecules involved in the Sonic Hedgehog pathway was similar in follicular thyroid adenoma, but Sonic Hedgehog expression was a more sensitive indicator of malignancy in papillary thyroid carcinoma. The Sonic Hedgehog molecule may become a diagnostic marker when the cytologic or histologic features are not characteristic of a papillary carcinoma. Greater understanding of the Sonic Hedgehog pathway may provide molecular methods for preventing or treating papillary thyroid carcinoma.
authors.affiliation: Rush Medical College, Chicago, IL, USA.
authors.forename: Kirbylee K
authors.initials: KK
authors.lastname: Nelson
authors.forename: Paolo
authors.initials: P
authors.lastname: Gattuso
authors.forename: Xiulong
authors.initials: X
authors.lastname: Xu
authors.forename: Richard A
authors.initials: RA
authors.lastname: Prinz
mesh_terms: D000231:Adenocarcinoma, Papillary / Q000378:metabolism*; D000236:Adenoma / Q000378:metabolism*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D053823:Hedgehog Proteins / Q000096:biosynthesis*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary; D011237:Predictive Value of Tests; D013961:Thyroid Gland / Q000378:metabolism; D013964:Thyroid Neoplasms / Q000378:metabolism*; D055815:Young Adult
chemical_list: D053823:Hedgehog Proteins; C509239:SHH protein, human