ArticleThe American journal of surgical pathology2020
A Proposed Grading Scheme for Medullary Thyroid Carcinoma Based on Proliferative Activity (Ki-67 and Mitotic Count) and Coagulative Necrosis.
Article in The American journal of surgical pathology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers.
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39 citing papers in PubMed, 77 citations in OpenAlex.
- MYELOstudy: lymph node stage of aggressiveness in medullary thyroid cancer-a retrospective multi-center study analysis.Updates in surgery · 2026Article
- Knowledge gaps in tubular gut tumours: a critical appraisal of the 6th edition of the World Health Organization classification of tumours.The Journal of pathology · 2026Review
- Immunohistochemical expression of Ki-67, INSM1, and SSTR2A in medullary thyroid carcinoma: correlation with tumour size, vascular invasion, and biochemical outcome.Virchows Archiv : an international journal of pathology · 2026Article
- Grading medullary thyroid carcinoma on fine needle aspiration biopsy specimens: a comparative study between manual counting and a deep learning platform.Journal of the American Society of Cytopathology · 2026Article
- Article
- Diagnostic Utility of Ki-67 Index on Cell Block Material for Grading Medullary Thyroid Carcinoma.Diagnostic cytopathology · 2026Article
- How to manage medullary thyroid carcinoma: current treatment strategies.Drugs in context · 2026Review
- Multi-omic analysis of SDHB-deficient pheochromocytomas and paragangliomas identifies metastasis and treatment-related molecular profiles.Nature communications · 2025Article
- Low Ki-67 labeling index is a clinically useful predictive factor for recurrence-free survival in patients with papillary thyroid carcinoma.Journal of pathology and translational medicine · 2025Article
- Article
- Histopathology of C Cells and Medullary Thyroid Carcinoma.Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer · 2025Review
- Epidemiology, Clinical Presentation, and Diagnosis of Medullary Thyroid Carcinoma.Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer · 2025Review
- The road ahead: a brief guide to navigating the 2022 WHO classification of endocrine and neuroendocrine tumours.Journal of clinical pathology · 2024Review
- Unusual Presentation of Metastatic Medullary Thyroid Cancer Involving Bone Marrow, Kidneys, and Adrenal Gland: A Literature Review Based on a Case Report.Cancer reports (Hoboken, N.J.) · 2024Review
- Multi-omic analysis of SDHB-deficient pheochromocytomas and paragangliomas identifies metastasis and treatment-related molecular profiles.Research square · 2024Article
- Molecular Pathology of Thyroid Tumors: Essential Points to Comprehend Regarding the Latest WHO Classification.Biomedicines · 2024Review
- International medullary thyroid carcinoma grading system: an Indian tertiary care centre experience.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2024Article
- Association of the Genomic Profile of Medullary Thyroid Carcinoma with Tumor Characteristics and Clinical Outcomes in an International Multicenter Study.Thyroid : official journal of the American Thyroid Association · 2024Article
- Management of medullary thyroid cancer based on variation of carcinoembryonic antigen and calcitonin.Frontiers in endocrinology · 2024Review
- Management of Medullary Thyroid Cancer: Patterns of Recurrence and Outcomes of Reoperative Surgery.The oncologist · 2023Article
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Authors and funding
15 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We investigated the prognostic value of a range of histologic parameters in medullary thyroid carcinoma (MTC) to design a grading system to predict overall survival. We assessed 76 patients with MTCs undergoing primary tumor resection for age, sex, tumor size, vascular space invasion, lymph node metastasis, multiple endocrine neoplasia type 2 (MEN2) status, mitotic count, Ki-67 proliferative index, spindled morphology, sheet-like growth pattern, coagulative necrosis, incipient necrosis, nuclear grade, multinucleation, prominent nucleoli, fibrosis, and amyloid deposition. In addition to the clinical features of age and the diagnosis of MEN2, the only histologic features that significantly predicted reduced overall survival were Ki-67 proliferative index, mitotic count, and the presence of coagulative necrosis. Using a combination of these 3 variables, we propose a 3-tiered grading system based solely on proliferative activity (Ki-67 proliferative index and mitotic count) and necrosis. There were 62 (82%) low-grade MTCs (low proliferative activity, no necrosis), 9 (12%) intermediate grade (low proliferative activity and necrosis present, or intermediate proliferative activity and no necrosis), and 5 (7%) high grade (intermediate proliferative activity and necrosis present, or high proliferative activity with or without necrosis). The mean overall survival was 193, 146, and 45 months, respectively (P=0.0001) for the 3 grades. The grading system remained prognostic when controlled for other factors associated with survival including age and known MEN2 syndrome. We conclude that this proposed grading system, which uses only a combination of proliferative activity (Ki-67 index, mitotic count) and coagulative necrosis, is a strong predictor of overall survival in MTC.
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