title: Histological growth pattern of and alpha-actinin-4 expression in thyroid cancer.
abstract: OBJECTIVE
  To assess the clinicopathological significance of the histological growth pattern (HGP) and α-actinin-4 (ACTN4) expression in thyroid cancer.
  
  
  METHODS
  We classified 83 thyroid cancer cases into infiltrative margin (IM) and pushing margin (PM) groups according to peripheral tumor margin contour and immunohistochemically determined ACTN4 expression. Correlations between clinical stage and clinicopathological characteristics were analyzed.
  
  
  RESULTS
  IM and high ACTN4 expression were observed in 39% and 49% of cancer cases, respectively. Higher clinical stage was significantly correlated with older age, higher T and N factor, preoperative recurrent laryngeal nerve paralysis (pre-RLNP), IM, and poor prognosis. Patients with stage IV disease had significantly poorer prognosis than those with stages I-III. On multivariate analysis, older age, pre-RLNP, and IM correlated with higher clinical stages. IM was significantly correlated with high ACTN4 expression.
  
  
  CONCLUSIONS
  IM, pre-RLNP, and ACTN4 expression could be novel indicators of tumor aggression and prognostic factors of thyroid cancer.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College, Saitama, Japan.
authors.forename: Nobuaki
authors.initials: N
authors.lastname: Tanaka
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College, Saitama, Japan tkym@ndmc.ac.jp.
authors.forename: Taku
authors.initials: T
authors.lastname: Yamashita
authors.affiliation: Department of Basic Pathology, National Defense Medical College, Saitama, Japan.
authors.forename: Sohei
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College, Saitama, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsunobu
authors.affiliation: Department of Basic Pathology, National Defense Medical College, Saitama, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tsuda
authors.affiliation: Division of Chemotherapy and Clinical Research, National Cancer Center Research Institute, Tokyo, Japan.
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Honda
authors.affiliation: Division of Chemotherapy and Clinical Research, National Cancer Center Research Institute, Tokyo, Japan.
authors.forename: Tesshi
authors.initials: T
authors.lastname: Yamada
authors.affiliation: Department of Clinical Laboratories, National Defense Medical College, Saitama, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Tamai
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College, Saitama, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Shiotani
mesh_terms: D000185:Actinin / Q000378:metabolism*; D018263:Adenocarcinoma, Follicular / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D018276:Carcinoma, Medullary / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D002291:Carcinoma, Papillary / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology*; D014826:Vocal Cord Paralysis / Q000175:diagnosis* / Q000378:metabolism; D055815:Young Adult
chemical_list: C111453:ACTN4 protein, human; D014408:Biomarkers, Tumor; D000185:Actinin
keywords: Thyroid; alpha-actinin-4; infiltrative margin; preoperative recurrent laryngeal nerve paralysis; pushing margin