Revised criteria for diagnosis of NIFTP reveals a better correlation with tumor biological behavior

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de Jesus Paniza, Ana Carolina ; Mendes, Thais Biude ; Borges Vianna, Matheus Duarte ; Dias Thomaz, Debora Mota ; Chiappini, Paula B. O. ; Colazza-Gama, Gabriel A. ; Lindsey, Susan Chow ; de Carvalho, Marcos Brasilino ; Ferreira Alves, Venancio Avancini ; Curioni, Otavio ; Bastos, Andre Uchimura ; Cerutti, Janete Maria

• Tipo de documento: Artigo Científico
• Fonte: ENDOCRINE CONNECTIONS; v. 8, n. 11, p. 10-pg., 2019-11-01.

Resumo

The recent reclassification of a follicular variant of papillary thyroid carcinoma (FVPTC), subset as noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP), aims to avoid overtreatment of patients with an indolent lesion. The diagnosis of NIFTP has recently been revisited using more rigid criteria. This study presents histological and molecular findings and a long clinical follow-up of 94 FVPTC, 40 cases of follicular adenoma (FTA) and 22 cases of follicular carcinoma (FTC) that were classified before the advent of the NIFTP reclassification. All slides were reviewed using these rigid criteria and analysis of numerous sections of paraffin blocks and reclassified as 7 NIFTPs, 2 EFVPTCs, 29 infiltrative FVPTC (IFVPTCs), 57 invasive EFVPTC (I-EFVPTCs), 39 FTAs and 22 FTCs. Remarkably, EFVPTC and NIFTP patients were all free of disease at the end of follow-up and showed no BRAF mutation. Only one NIFTP sample harbored mutations, an NRAS Q61R. PAX8/PPARG fusion was found in I-EFVPTCs and FTC. Although additional studies are needed to identify a specific molecular profile to aid in the diagnosis of lesions with borderline morphological characteristics, we confirmed that the BRAFV600E mutation is an important tool to exclude the diagnosis of NIFTP. We also show that rigorous histopathological criteria should be strongly followed to avoid missing lesions in which more aggressive behavior is present, mainly via the analysis of capsule or vascular invasion and the presence of papillary structures. (AU)

• Processo FAPESP: 14/06570-6 - Sequenciamento completo do exoma, Paired-end RNA e genoma: novos insights sobre a natureza genética do câncer de tiróide na idade adulta e na faixa etária pediátrica e aplicações na prática clínica
• Beneficiário: Janete Maria Cerutti
• Modalidade de apoio: Auxílio à Pesquisa - Temático
• Processo FAPESP: 16/25784-2 - Mecanismos de resistência ao tratamento com temozolomida em células de glioma
• Beneficiário: André Uchimura Bastos
• Modalidade de apoio: Bolsas no Brasil - Pós-Doutorado
• Processo FAPESP: 17/16315-1 - Análise da prevalência do rearranjo STRN-ALK nos tumores de célula de Hürthle
• Beneficiário: Débora Mota Dias Thomaz
• Modalidade de apoio: Bolsas no Brasil - Iniciação Científica
• Processo FAPESP: 17/06487-0 - Identificação do perfil metabólico das células com expressão ectópica de PVALB e investigação do mecanismo molecular associado sua expressão nos adenomas de células de Hürthle
• Beneficiário: Thais Biude Mendes
• Modalidade de apoio: Bolsas no Brasil - Doutorado