Abstract 3817: Nestin is an independent molecular prognostic factor in patients with anaplastic thyroid carcinoma
Authors: Kurata Kento , Onoda Naoyoshi , Satoru Noda , Kashiwagi Shinichiro , Asano Yuka , Miura Kotarou , Go Yukie , Kasashima Hiroaki , Kawajiri Hidemi , Takashima Tsutomu , Hirakawa Kosei 
Published: May 2015

Abstract
Introduction: Nestin, a 200-220 kDa intermediate filament protein, is considered as a neuronal stem cell marker reportedly expressed in newly formed blood vessels of various neoplasms such as glioblastoma, prostate cancer, pancreatic cancer and colorectal cancer. Expression of nestin indicates poorer prognosis in various tumors. Although rare, anaplastic thyroid carcinoma (ATC) is one of the most aggressive malignancies of human, often showed resistance to the multimodal therapeutic approach, and resulted in fatal outcome within half a year in most of the patients. Although several clinical prognostic factors were reported, no molecular background has been demonstrated to indicate its prognosis to date. In this study, the association between nestin expression and prognosis in patient with ATC was evaluated.
Methods: We analyzed 23 histologically confirmed ATC patients (12 males and 11 females; mean age, 71.0 years; range, 31-88 years). Formalin-fixed, paraffin-embedded tissue samples were subjected to imunohistochemical staining (10c2, mouse monoclonal Ab; Santa Cruz, CA). Positive staining was defined when cytoplasmic staining was observed in 10% or more ATC cells at the same intensity as newly formed blood vessels. Fishere's exact test was used to compare the variables. Survival data were estimated by the Kaplan-Meier method. The Cox proportional hazards model was used for the multivariate survival analysis. A p-value5cm in diameter), distant metastasis and leukocytosis (&gt;10000/mm3) were reported as significant clinical risk factors for poor prognosis, defined as prognostic index (PI) [Sugitani et al. WJS 2010], and were included as clinical prognostic indicators in this study.
Results: Expression of nestin was confirmed in 6 of 23 tissue samples (26.1%). There was no correlation between expression of nestin and clinicopathological factors including age, gender, acute symptoms, tumor size, number of leukocyte, stage of cancer, lymph node metastasis and distant metastasis. Nestin positive group (n=6) showed a significantly worse prognosis than nestin negative group (n=17) (median survival time, 86.5 vs. 306 days; p&lt;0.01; HR, 4.26; 95% CI, 1.32 to 13.41). The univariate analysis demonstrated that the 6 months survival rate of patients with nestin-positive tumors or PI-high was significantly poorer than that of those with nestin-negative tumors (p&lt;0.01) or PI-low (p&lt;0.01). The multivariate analysis indicated that nestin expression and PI were independent prognostic indicators for patient survival.
Conclusion: Nestin expression is an independent molecular indicator of poor prognosis for patients with ATC.
Citation Format: Kento Kurata, Naoyoshi Onoda, Noda Satoru, Shinichiro Kashiwagi, Yuka Asano, Kotarou Miura, Yukie Go, Hiroaki Kasashima, Hidemi Kawajiri, Tsutomu Takashima, Kosei Hirakawa. Nestin is an independent molecular prognostic factor in patients with anaplastic thyroid carcinoma. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3817. doi:10.1158/1538-7445.AM2014-3817