Background: Poorly differentiated thyroid cancer (PDTC) is a rare, follicular cell-derived neoplasm with unfavorable prognosis. The oncocytic variant of PDTC may be associated with even more adverse outcome than classical PDTC cases, but its specific molecular features are largely unknown. Our aim was to explore the immune-related gene expression profile of oncocytic and classical PDTC, in correlation with clinical and pathological characteristics (including PD-L1 expression) and outcome, and in comparison with a control group of well differentiated follicular carcinomas (WDFC), including conventional follicular carcinomas (FTC) and Hürthle cell carcinomas (HCC).
Methods: A retrospective series of 48 PDTC and 24 WDFC was analyzed by means of NanoString technology employing nCounter PanCancer Immune Profiling panel. Gene expression data were validated using quantitative real time PCR.
Results: Oncocytic PDTC showed a specific immune-related gene expression profile, with higher expression of LAIR2, CD274, DEFB1, IRAK1, CAMP, LCN2, LY96, and APOE, and lower expression of NOD1, as compared to conventional PDTCs. This molecular signature was associated with increased intra-tumoral lymphocytic infiltration, PD-L1 expression and adverse outcome. Three of these genes, CD274, DEFB1, IRAK1, as well as PD-L1 expression, were also the hallmarks of HCCs as compared to FTCs. By contrast, the panel of genes differentially regulated in PDTCs as compared to WDFCs was unrelated to the oncocytic phenotype.
Conclusions: Our results revealed a distinctive immune-related gene expression profile of oncocytic PDTC and confirmed a more aggressive outcome in this cancer subtype. These findings may provide guidance when exploring novel immunotherapeutic options for oncocytic PDTC patients.
Keywords: NanoString; Poorly differentiated thyroid carcinoma; biomarkers; immune-related genes; oncocytic.