Among oncogenes studied in thyroid cancers, a specific activated form of c-
ret has been found in a minority of papillary thyroid carcinomas (PTCs). In
these tumours, c-ret is activated when by somatic rearrangements, the intr
acellular domain of RET is juxtaposed with the amino-terminal portion of a
different donor gene such as H4, thereby generating a chimeric transcript (
ret/PTC-1). The functional effects of c-ret activation and its prognostic i
mplications are currently unclear. This study was undertaken to assess the
frequency of RET/PTC-1 expression, any distinctive features of positive tum
ours to which it might be related, and its prognostic importance. Archival
material from 88 thyroid neoplasms [50 PTCs, eight anaplastic carcinomas (A
TCs), 25 follicular thyroid carcinomas (FTCs) and five follicular adenomas
(FAs)] were analysed for ret/PTC-1 and H4 expression using 5' nuclease assa
y (TaqMan RT-PCR). RNA from the TPC-I cell line was included as a positive
control for c-ret activation. No FTC or FA displayed activation of ret/PTC-
1, though all expressed H4. c-ret activation was found in 24% of PTCs (12 o
f 50), in 87.5% of ATCs (7 of 8), and in 33% of the combined PTC/ATC group.
The frequency of c-ret activation in the aggressive ATC variants noted her
e suggests that ret/PTC-1-positive PTCs might also have a similar poor prog
nosis and a follow-up study on this cohort is in progress. Ninety per cent
of ret/PTC-1-positive tumours failed to express H4, a phenomenon that has n
ot been described previously and which may have considerable bearing on tum
our morphology. A statistically significant proportion (58%) of ret/PTC-1-p
ositive, H4-negative PTCs was associated with chronic inflammatory cell inf
iltration of the tumour and/or the surrounding thyroid. This association ha
s not been reported previously. Copyright (C) 2000 John Wiley & Sons, Ltd.