CD105 (Endoglin) Expression as a Prognostic Marker in Aggressive Papillary Thyroid Carcinoma.

Abstract

Background: Papillary thyroid carcinoma (PTC) is the most common type of thyroid malignancy, with a generally favourable prognosis. However, a subset of PTC cases exhibit aggressive behaviour, including lymph node and distant organ metastases. Identifying biomarkers that can differentiate between benign and malignant lesions, as well as predict tumour aggressiveness, is crucial for improving diagnosis and management. CD105 (endoglin), a marker of neoangiogenesis, has shown promise in various solid tumours as a prognostic factor. Its role in PTC, particularly in distinguishing between metastatic and non-metastatic cases, remains underexplored.

Aims: To investigate the role of CD105 (endoglin) expression in the differential diagnosis and prognostic evaluation of patients with benign thyroid nodules, non-metastatic PTC, and PTC with lymph node metastasis (LNM).

Methods: Thyroid tissues from 148 patients were retrospectively analyzed for CD105 expression, including 49 with thyroid follicular nodular disease (TFND), 48 with PTC without LNM [LNM(-) PTC], and 51 with PTC and LNM [LNM(+) PTC]. Tissues were classified based on CD105 expression, and microvascular density (MVD) scores were calculated using the Weidner method in positive cases. Clinical and pathological features were compared across TFND, LNM(-), and LNM(+) groups.

Results: The rates of CD105 expression significantly differed between the TFND, LNM(-) PTC, and LNM(+) PTC groups (8.2%, 64.6%, and 80.4%, respectively). The CD105 MVD score was significantly higher in the LNM(+) PTC, unifocal LNM(+) PTC, and multifocal LNM(+) PTC groups, in favour of metastasis (p < 0.001). CD105 expression was detected in all patients with distant organ metastasis, and these patients also exhibited significantly higher MVD scores (p < 0.001).

Conclusion: This study supports the potential use of CD105 expression and its quantitative indicator, the CD105 MVD score, as biomarkers for distinguishing benign thyroid nodules from malignant ones and for evaluating the prognosis of PTC.