Is papillary thyroid microcarcinoma a biologically different disease? A propensity score-matched analysis

J Surg Oncol. 2019 Nov;120(6):1023-1030. doi: 10.1002/jso.25670. Epub 2019 Aug 12.

Abstract

Background: Papillary thyroid microcarcinoma exhibits an indolent clinical course and could be a candidate for active surveillance in the appropriate setting. It remains unknown whether papillary microcarcinoma is biologically different from larger papillary carcinoma >1 cm.

Methods: We analyzed clinicopathological information and transcriptome data of papillary thyroid cancer samples from The Cancer Genome Atlas. Propensity-score matching was used to construct a matched cohort consisting of 29 microcarcinomas and 58 carcinomas. Principal component analysis and unsupervised hierarchical cluster analysis were carried out to investigate the similarity of gene expression profiles.

Results: After adjustment for differences in baseline clinicopathological and genetic factors, transcriptome could be grouped mainly on the basis of tumor class (BRAF-like vs RAS-like) and tumor size (microcarcinoma vs carcinoma). The gene set enrichment analysis showed that extracellular matrix-associated pathways were enriched in the MSigDB database.

Conclusion: Papillary thyroid microcarcinomas display a distinct gene expression pattern different from the corresponding carcinomas. We hypothesize that tumor microenvironment may play a role in the microcarcinoma/carcinoma phenotypic divergence.

Keywords: microcarcinoma; propensity score matching; thyroid carcinoma; transcriptome.

MeSH terms

  • Adult
  • Biomarkers, Tumor / genetics*
  • Carcinoma, Papillary / classification
  • Carcinoma, Papillary / genetics
  • Carcinoma, Papillary / pathology*
  • Case-Control Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Mutation
  • Prognosis
  • Propensity Score*
  • Retrospective Studies
  • Survival Rate
  • Thyroid Neoplasms / classification
  • Thyroid Neoplasms / genetics
  • Thyroid Neoplasms / pathology*
  • Transcriptome*

Substances

  • Biomarkers, Tumor

Supplementary concepts

  • Papillary Thyroid Microcarcinoma