High frequency of level ii-v lymph node involvement in ret/ptc positive papillary thyroid carcinoma.

High frequency of level II-V lymph node involvement in RET/PTC positive papillary thyroid carcinoma.
Eur J Surg Oncol. 2007 Oct 20;
Authors: Wang YL, Zhang RM, Luo ZW, Wu Y, Du X, Wang ZY, Zhu YX, Li DS, Ji QH
AIMS: To investigate the frequency and clinical significance of RET rearrangement in Chinese patients with papillary thyroid carcinoma (PTC) and discuss the role of RET rearrangement in therapeutic decision-making after the performance of level VI lymph node dissection and the 2002 AJCC staging system. METHODS: RET/PTC-1 and RET/PTC-3 were detected in 126 PTCs using reverse transcription-polymerase chain reaction (RT-PCR) and direct sequencing. RESULTS: RET rearrangement was detected in 18 cases of PTC. The patient group aged <20years had the highest frequency (3/6) of RET rearrangement among the age groups (<20years, 20-40years and >/=40years; P=0.03). RET/PTC-1 positive patients were more likely to suffer from Hashimoto's thyroiditis simultaneously (P=0.02) while RET/PTC-3 positive patients had a higher frequency of extrathyroidal extension (P<0.01) and advanced T classification (P<0.01). RET rearrangement (OR=8.70, 95% CI 1.69-44.81), male (OR=3.88, 95% CI 1.41-10.69), age (OR=0.96, 95% CI 0.93-0.99), multifocality (OR=3.54, 95% CI 1.33-9.41) and advanced T classification (OR=7.32, 95% CI 2.91-18.40) were all identified as risk factors of level II-V lymph node involvement in the multivariate analysis. CONCLUSIONS: The frequency of RET rearrangement in Chinese patients is low and age related. RET/PTC-1 and RET/PTC-3 are associated with different clinical pathological characteristics but not with lymph node involvement. The RET/PTC positive patients should receive more attention to lateral neck in the management of PTC.
PMID: 17954023 [PubMed - as supplied by publisher] (Source: European Journal of Surgical Oncology)