Markers of cell-proliferation as prognostic factors in differentiated XXXX .

@entity5 @entity1 @entity259 @entity1364
Age is the most accepted prognostic factor in @entity259 . Other parameters, such as @entity5 size, grading, extrathyroidal extension, have also been associated with the prognosis of these @entity5 . Since the identification of reliable prognostic factors is essential to avoid unnecessary aggressive treatment for a disease, such as @entity259 , which only rarely is fatal, we studied two indices of cell proliferation in @entity1 with @entity259 , in relation to their outcome. We studied two groups of @entity1 with @entity259 , selected in a way to have one group (33 @entity1 ) with a good outcome and one (16 @entity1 ) with a fatal outcome, after a follow-up of at least 5 years. By immunohistochemistry the @entity5 of all @entity1 were analyzed for the expression of the @entity1364 ( @entity1364 )/ @entity1364 . In 38 (77.5%) of them also the nuclear DNA content and the percentages of S-phases were analyzed by flow cytometric analysis. At diagnosis the two groups of @entity1 differed significantly with regard to age and extrathyroidal extension, but not for @entity5 size and grading. A significant difference (p=0.02) was found in the positivity of @entity1364 / @entity1364 expression between the fatal outcome group (66.6%) and the surviving @entity1 (27%), and in the percentage of cells in the S-phase, 16.4+/-7.7% in the fatal outcome group @entity1 and 6.0+/-2.6% in the surviving @entity1 (p=0.0001). No difference was found in the nuclear DNA content of the two groups. A positive correlation was found between @entity1364 expression and S-phase (r(s)=0.55; p<0.001). A positive correlation was found between age and both the percentage of S-phase cells (r(s)=0.48; p<0.002) and @entity1364 expression (r(s)=0.36; p<0.009). In a multivariate analysis (Cox model) age and S-phase had independent prognostic significance (regression coefficient: 3.85 and 1.70, respectively), while @entity1364 was not an independent variable (0.98). Our results indicate that differentiated @entity259 with fatal outcome are characterized by two parameters of active cell proliferation (S-phase cell fraction and @entity1364 expression), which can be used as useful prognostic factors.
