Association of DLL3 Gene Expression with Lymph Node Metastasis in Iraqi Patients with Sporadic Medullary Thyroid Carcinoma
DOI:
https://doi.org/10.31185/bsj.Vol21.Iss38.1522Keywords:
medullary thyroid carcinoma; DLL3; lymph node metastasis; neuroendocrine tumors; thyroid cancerAbstract
Medullary thyroid carcinoma (MTC) is a rare and highly aggressive neuroendocrine tumor of the thyroid gland. Around three-fourths of cases are sporadic, and in 50% of these cases, there are somatic mutations in the RET proto-oncogene. Recently, delta-like ligand 3 (DLL3), which is broadly expressed in neuroendocrine tumors, emerged as a new target molecule. Therefore, the current analysis of the correlation of the overexpression of the DLL3 gene and its clinical value is of great interest. In this work, a total of 69 formalin-fixed, paraffin-sectioned sporadic medullary thyroid carcinoma samples were studied. Among those, 48 cases were already known to be associated with confirmed lymph node metastases, and 21 cases were stage I or stage II MTC without nodal involvement. Expression of the DLL3 gene was evaluated by RT-qPCR and correlated with clinical and pathological factors. High DLL3 gene expression was remarkably correlated with lymph node involvement, whereas tumors without stromal desmoplasia consistently exhibited an absence of DLL3 expression. These data emphasize the role of the DLL3 gene in MTC and its correlation with disease aggressiveness. It appears that DLL3 is an accurate surrogate marker for the presence of lymph node metastases and may similarly reflect disease aggressiveness. Given the theoretically promising role of DLL3 in the treatment of other tumors that express the gene, DLL3 may also serve as an alternative therapeutic target in MTC.
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