Background: Leukocytosis is an independent prognostic factor for anaplastic thyroid carcinoma (ATC). In the present study, the potential causes of leukocytosis in ATC were analyzed.
Methods: This study involved 22 patients with histologic or cytologic evidence of ATC, as well as papillary thyroid carcinoma (PTC), between June 2000 and October 2009. Samples were obtained from ATC patients before treatment. The xMAP serum assay for 17 cytokines [IL-1β, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IL-13, and IL-17, TNF-α, IFN-γ, GM-CSF, G-CSF, MIP-1β, and MCP-1] and IHC from surgical specimens were performed.
Results: WBC was ≥ 10000/mm3 in 9 (41%) and G-CSF was ≥ 100 pg/ml in 4 (18%) ATC cases. The G-CSF level showed a positive correlation with the WBC count in ATC cases (r=0.78). Both G-CSF and G-CSFR protein expressions were seen on immunohistochemical staining in 50% (5/10) and 70% (7/10) of ATC cases, respectively. Serum IL-6, IL-7, IL-8, IL-12, IL-17, MCP-1, TNF-α, and G-CSF concentrations were significantly higher in ATC than in PTC. WBC and G-CSF (r=0.61) had a positive correlation (>0.6). Patients with leukocytosis (n=9) had a poorer survival rate than those with WBC<10000/mm3 (p=0.0002). Similarly, patients with G-CSF ≥ 100 pg/ml had a poorer survival rate than those with G-CSF <100 pg/ml (p=0.0107).
Conclusion: Leukocytosis and a high G-CSF level before treatment are linked to poor prognosis in ATC patients.