title: Thyroid Hürthle cell tumors: research of potential markers of malignancy.
abstract: BACKGROUND
  Hurthle cell tumors (HCTs) are rare thyroid neoplasia. To date, capsular and/or vascular invasion are the only findings predicting malignancy. Recently, mutation of 19p13, encoding two proteins involved in cell proliferation and apoptosis (GRIM-19 and p19), has been described. The aim of our study is to evaluate the cellular proliferation index (Ki67), GRIM-19 and p19 expression as diagnostic markers of malignancy in HCT.
  
  
  METHODS
  Eighty patients with HCT (32 carcinomas, 48 adenomas) whom underwent surgery in our center were included. Samples of both neoplastic lesions and adjacent normal thyroid tissue were analyzed by means of tissue micro-arrays. Correlations between expressions of Ki67, GRIM-19 and p19 and final histology were analyzed.
  
  
  RESULTS
  Mean size of the lesion was higher in carcinomas than in adenomas (p = 0.01). GRIM-19 and p19 were significantly underexpressed in Hurthle cells tumors compared to normal tissue (p = 0.0004 and p = 0.0001, respectively). Ki67 and GRIM-19 were, respectively, higher and down-expressed in carcinomas compared to adenomas (p = 0.0004 and p = 0.005, respectively). On multivariate analysis, size correlates with carcinoma diagnosis. Neither GRIM-19 nor Ki67 index was related to size. The expression of p19 was reduced in both adenoma and carcinoma but differences were not statistically significant (p = 0.13).
  
  
  CONCLUSIONS
  Our study suggest that Ki67 and GRIM-19 correlate with malignancy in HCT. The expression of p19 is down-regulated in HCT, but it is not diagnostic of carcinoma. Ki67 and GRIM-19 may potentially help as cytological markers of malignancy in HCT.
authors.affiliation: Department of General and Endocrine Surgery, CHU Poitiers, 2 Rue de la Miletrie, 86021, Poitiers, France. giacko76@hotmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Donatini
authors.affiliation: Department of General and Endocrine Surgery, CHU Poitiers, 2 Rue de la Miletrie, 86021, Poitiers, France.
authors.forename: A
authors.initials: A
authors.lastname: Beaulieu
authors.affiliation: Department of General and Endocrine Surgery, CHU Poitiers, 2 Rue de la Miletrie, 86021, Poitiers, France.
authors.forename: M
authors.initials: M
authors.lastname: Castagnet
authors.affiliation: Department of General and Endocrine Surgery, CHU Poitiers, 2 Rue de la Miletrie, 86021, Poitiers, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Kraimps
authors.affiliation: Department of Pathology, CHU Poitiers, 2 Rue de la Miletrie, 86021, Poitiers, France.
authors.forename: P
authors.initials: P
authors.lastname: Levillain
authors.affiliation: Department of Pathology, CHU Poitiers, 2 Rue de la Miletrie, 86021, Poitiers, France.
authors.forename: G
authors.initials: G
authors.lastname: Fromont
mesh_terms: D000236:Adenoma / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D018249:Adenoma, Oxyphilic / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis; D051017:Apoptosis Regulatory Proteins / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000378:metabolism; D002277:Carcinoma / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D049109:Cell Proliferation; D015331:Cohort Studies; D005260:Female; D006801:Humans; D053760:Interleukin-23 Subunit p19 / Q000378:metabolism; D019394:Ki-67 Antigen / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009247:NADH, NADPH Oxidoreductases / Q000378:metabolism*; D009363:Neoplasm Proteins / Q000378:metabolism*; D013961:Thyroid Gland / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D013964:Thyroid Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy; D047368:Tumor Burden
chemical_list: D051017:Apoptosis Regulatory Proteins; D014408:Biomarkers, Tumor; C508840:IL23A protein, human; D053760:Interleukin-23 Subunit p19; D019394:Ki-67 Antigen; D009363:Neoplasm Proteins; D009247:NADH, NADPH Oxidoreductases; C439057:NDUFA13 protein, human
keywords: Hürthle cell tumors; Immune-histochemical markers; Thyroid malignancy markers