Abstract
Papillary thyroid carcinoma (PTC) has a relatively good prognosis, yet there are some invasive PTC cases with worse clinicopathological features and poor outcome. Cancer-associated fibroblasts (CAFs) play an important role in cancer invasion and metastasis. This study aimed to investigate the expression of marker proteins of CAFs in PTC and their correlations with clinicopathological features through immunohistochemistry. The medical records of 125 PTC patients were reviewed in this study, whose specimens were retrieved for immunohistochemistry. Four CAFs marker proteins, FAP fibroblast activated protein (FAP), α-smooth muscle actin (α-SMA), Vimentin and platelet-derived growth factor receptor-α(PDGFR-α), were stained and scored. Then, statistical analyses were performed. The immunoreactivity scores of FAP and α-SMA correlated with tumor size, BRAF mutation, extrathyroidal, invasion, pathological subtype, lymph node metastasis and ATA risk stratification. Moreover, binary logistic regression analysis and receiver operating characteristic curves showed that high FAP and α-SMA immunoreactivity scores were risk factors for extrathyroidal invasion, BRAF mutation, multi-focality and lymph node metastasis (especially N1b) with good sensitivity and accuracy in prediction. A better performance was found in FAP than α-SMA. Strong expressions of CAFs were risk factors for worse thyroid cancer clinicopathological features. FAP was the better CAFs marker for PTC.
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Funding
This work was supported by Tianjin Science and Technology Committee Foundation Grant 21JCYBJC01820. This study was also funded by the National Natural Science Foundation of China grants (#81571709 and #81971650).
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All authors contributed to the study implementation (patient treatment, specimen management, immunohistochemistry, etc.). Material preparation, data collection and analysis were performed by LZ, XZ, SZ, ZM. ZM,GZ and KX contributed in conception and design of the study. The first draft was written by LZ, and all authors commented and approved the final manuscript.
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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Tianjin Medical University General Hospital.
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Zhu, L., Zhang, X., Zhang, S. et al. Cancer-associated fibroblasts in papillary thyroid carcinoma. Clin Exp Med 23, 2209–2220 (2023). https://doi.org/10.1007/s10238-023-00998-2
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DOI: https://doi.org/10.1007/s10238-023-00998-2