Background: Thyroid cancer is one of the increasing cancers diagnosed in Western as well as Eastern countries. Papillary thyroid cancer (PTC) is the most common thyroid cancer. Few researches are done determining the role of Her 2/neu in PTC diagnosis as well as prognosis which have been contradictory to each other. Thus the present study is aimed at correlation of the Her 2/neu expression with various prognostic factors such as tumour size, different subtypes, multifocality, capsular involvement with extra-thyroidal extension and lymph node metastasis.

Materials and Methods: The study period was performed from January 2016 to December 2018 in pathology department of IMS and SUM hospital. Of total 83 total/subtotal thyroidectomy cases received, 25 cases were diagnosed as papillary carcinoma on haematoxylin and eosin histology sections. The detailed clinico-pathological parameters were noted in these patients and were further subjected to immunohistochemistry for Her 2/neu expression.

Results and Observations: In the study, female (60%) predominance was there and the age ranged from 14 years to 70 years. Majority of these tumours presented as solitary cold nodules but for 24% cases with multifocality. Total 7 cases (28%) showed Her 2/neu positivity (3+) and majority belonged to low risked group. Strong correlation was found between tumour size, multifocality and lymph node metastasis. No correlation was found with extra-thyroid extension or vascular invasion.

Conclusion: Variable Her2/neu positivity was seen in different variants of PTC as well as different clinical parameters

Study type and design: Hospital based cross sectional study and is an observational study.

Keywords: Her 2/neu, papillary thyroid carcinoma, thyroid neoplasm, prognosis.

1. Hegedus L. Clinicalpractice. The thyroid nodule. N Engl J Med.2004;351:1764-71.
2. Jameson J, Weetman A. Disorders of thyroid gland. In: Longo D, Fauci A, Kasper D, Hauser S, Jameson J, Loscalzo J, editors. Harrison’s Principles of Internal Medicine. 18th ed. New York: McGraw Hill; 2012. p. 2911‑40.
3. Lal G, Clark O. Thyroid, parathyroid and adrenal. In: Brunicardi F, Anderson D, Billiar T, Dunn D, Hunter J, Matthews J, editors. Schwartz’s Principles of Surgery. 9th ed. New York: McGraw‑Hill; 2010. p. 2587‑717.
4. Rosai J, Tallini G. Thyroid gland. In: Rosai J, editor. Rosai and Ackerman’s Surgical Pathology. 10th ed. New York: Elsevier; 2011. p. 488‑565.
5. Leboulleux S, Rubino C, Baudin E, Caillou B, Hartl DM, Bidart JM, et al. Prognostic factors for persistent or recurrent disease of papillary thyroid carcinoma with neck lymph node metastases and/or tumor extension beyond the thyroid capsule at initial diagnosis. J Clin Endocrinol Metab 2005;90:5723‑9.
6. Ciampi R, Knauf JA, Kerler R, Gandhi M, Zhu Z, Nikiforova MN, et al. Oncogenic AKAP9‑BRAF fusion is a novel mechanism of MAPK pathway activation in thyroid cancer. J Clin Invest 2005;115:94‑101.
7. Kimura ET, Nikiforova MN, Zhu Z, Knauf JA, Nikiforov YE, Fagin JA. High prevalence of BRAF mutations in thyroid cancer: Genetic evidence for constitutive activation of the RET/PTC‑RAS‑BRAF signaling pathway in papillary thyroid carcinoma. Cancer Res 2003;63:1454‑7.
8. Bazley LA, Gullick WJ. The epidermal growth factor receptor family. Endocr Relat Cancer 2005;12 Suppl 1:S17‑27.
9. Kato S, Kobayashi T, Yamada K, Nishii K, Sawada H, Ishiguro H, et al. Expression of erbB receptors mRNA in thyroid tissues. Biochim Biophys Acta 2004;1673:194‑200.
10. Balta AZ, Filiz AI, Kurt Y, Sucullu I, Yucel E, Akin ML. Prognostic value of oncoprotein expressions in thyroid papillary carcinoma. Med Oncol 2012;29:734‑41.
11. Kremser R, Obrist P, Spizzo G, Erler H, Kendler D, Kemmler G, et al. Her2/neu overexpression in differentiated thyroid carcinomas predicts metastatic disease. Virchows Arch 2003;442:322‑8.
12. Wolff AC, et al. Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline Focused Update.Arch Pathol Lab Med.2018 Nov;142(11):1364-1382.
13. Delia Ciobanu Apostol et al. HER-2/neu expression in different histological subtypes of papillary thyroid carcinoma. Rom J Morphol Embryol 2017, 58(2):439–444.
14. Rabiee S, Nadoushan MJ, Rayeni NM, Ansari I. Correlation between human epidermal growth factor receptor 2 oncoprotien expression and some prognostic factors in papillary thyroid carcinoma. Indian J Microbiol 2017;60:324-7.
15. Kim, Yong-Seon & Kim, Jeong-Soo & Kim, Yong. (2018). EGFR and HER2 Expression in Papillary Thyroid Carcinoma. Journal of Endocrine Surgery. 18. 228. 10.16956/jes.2018.18.4.228.

Debahuti Mohapatra

Professor and Head, Dept of Pathology, IMS and SUM Hospital, Bhubaneswar- 751003, Odisha, India

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