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Xiaoli Jin Department of General Surgery, Ruijin Hospital Lu Wan Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China

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Jiankang Shen Department of General Surgery, Ruijin Hospital Lu Wan Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China

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Tao Liu Department of General Surgery, Ruijin Hospital Lu Wan Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China

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Ru Zhou Department of General Surgery, Ruijin Hospital Lu Wan Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China

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Xunbo Huang Department of General Surgery, Ruijin Hospital Lu Wan Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China

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Tianxiang Wang Department of General Surgery, Ruijin Hospital Lu Wan Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China
Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Weize Wu Department of General Surgery, Ruijin Hospital Lu Wan Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China
Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Mingliang Wang Department of General Surgery, Ruijin Hospital Lu Wan Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China
Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

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Rongli Xie Department of General Surgery, Ruijin Hospital Lu Wan Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China

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Jianming Yuan Department of General Surgery, Ruijin Hospital Lu Wan Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China

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Introduction Thyroid cancer is one of the most common malignant tumors, and papillary thyroid carcinoma (PTC) is the most common histologic type ( 1 ). Surgery remains the most effective treatment for thyroid cancer. However, postoperative

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Weiwei Liang W Liang, Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

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Junxin Chen J Chen, Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University, Guang Zhou, China

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Hai Li H Li, Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

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Pengyuan Zhang P Zhang, Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

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Hongyu Guan H Guan, Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

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Yanbing Li Y Li, Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-sen University, Guanzhou, China

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Background: Collagen type VIII α 1 chain (COL8A1), a collagen type VIII protein, has been suggested to exert various functions in progression of multiple cancers. However, the effect of COL8A1 in papillary thyroid cancer (PTC) has not been elucidated.

Methods: The Cancer Genome Atlas (TCGA) databases were applied to investigate the COL8A1 expression and its clinical significance in PTC. The COL8A1 expression level was further validated using Gene Expression Omnibus (GEO) data and clinical paired PTC tissues. Additionally, Kaplan-Meier curve was used to analyze the prognosis. The cell migrative and invasive abilities were evaluated by wound healing assay and Transwell assay. CCK8 assays were used to evaluate proliferation of PTC cells. Western blotting was conducted to explore the potential mechanisms involved in the pro-tumor role of COL8A1. The correlation between immune cell infiltration and COL8A1 was analyzed using Tumor Immune Estimation Resource (TIMER) database and the single-sample GSEA (ssGSEA) method.

Results: We found that COL8A1 was upregulated in PTC (P<0.05). High COL8A1 expression level was significantly associated with advanced T stage (P<0.01), N stage (P<0.001) and poor prognosis (P=0.0142) in PTC. Furthermore, cell migration and invasion were significantly reduced following COL8A1 knockdown (P<0.001). Mechanistic studies demonstrated that the epithelial-to-mesenchymal transition (EMT) related proteins (FN1, MMP9, MMP7, ZEB2 and Twist1) and phosphorylation of AKT and ERK were obviously down-regulated after COL8A1 knockdown (P<0.01). Moreover, COL8A1 expression was correlated with immune cell infiltration.

Conclusion: Our study demonstrates that COL8A1 may function as an oncogene and a potential prognostic biomarker for PTC patients.

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Tiemo S Gerber Endocrine Surgery Section, Department of General, Visceral and Transplantation Surgery, University Medicine, Mainz, Germany

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Arno Schad Department of Pathology, University Medicine, Mainz, Germany

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Nils Hartmann Department of Pathology, University Medicine, Mainz, Germany

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Erik Springer Department of Pathology, University Medicine, Mainz, Germany

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Ulrich Zechner Institute of Human Genetics, University Medicine, Mainz, Germany

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Thomas J Musholt Endocrine Surgery Section, Department of General, Visceral and Transplantation Surgery, University Medicine, Mainz, Germany

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Introduction Poorly differentiated thyroid carcinoma (PDTC) represents an aggressive variant of thyroid cancer that predominantly arises from the differentiated variants of papillary and follicular thyroid carcinoma (PTC and FTC, respectively

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Rui M B Maciel Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil

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Cleber P Camacho Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil

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Lígia V M Assumpção Faculdade de Ciências Médicas, Universidade de Campinas, Campinas, São Paulo, Brazil

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Natassia E Bufalo Faculdade de Ciências Médicas, Universidade de Campinas, Campinas, São Paulo, Brazil

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André L Carvalho Hospital de Câncer de Barretos, Barretos, São Paulo, Brazil

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Gisah A de Carvalho Faculdade de Medicina, Universidade Federal do Paraná, Curitiba, Paraná, Brazil

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Luciana A Castroneves Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
Instituto do Câncer do Estado de São Paulo, São Paulo, São Paulo, Brazil

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Francisco M de Castro Jr Universidade Federal do Ceará, Fortaleza, Ceará, Brazil

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Lucieli Ceolin Hospital de Clínicas de Porto Alegre and Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

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Janete M Cerutti Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil

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Rossana Corbo Instituto Nacional do Câncer, Rio de Janeiro, Rio de Janeiro, Brazil

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Tânia M B L Ferraz Hospital Geral de Fortaleza, Fortaleza, Ceará, Brazil

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Carla V Ferreira Hospital de Clínicas de Porto Alegre and Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

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M Inez C França Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
Hospital Santa Rita de Cássia, Vitória, Espírito Santo, Brazil

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Henrique C R Galvão Hospital de Câncer de Barretos, Barretos, São Paulo, Brazil

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Fausto Germano-Neto Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil

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Hans Graf Faculdade de Medicina, Universidade Federal do Paraná, Curitiba, Paraná, Brazil

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Alexander A L Jorge Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil

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Ilda S Kunii Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil

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Márcio W Lauria Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil

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Vera L G Leal Instituto Estadual de Diabetes e Endocrinologia, Rio de Janeiro, Rio de Janeiro, Brazil

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Susan C Lindsey Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil

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Delmar M Lourenço Jr Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
Instituto do Câncer do Estado de São Paulo, São Paulo, São Paulo, Brazil

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Léa M Z Maciel Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil

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Patrícia K R Magalhães Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil

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João R M Martins Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil

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M Cecília Martins-Costa Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
Hospital Geral de Fortaleza, Fortaleza, Ceará, Brazil
Universidade de Fortaleza, Fortaleza, Ceará, Brazil

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Gláucia M F S Mazeto Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil

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Anelise I Impellizzeri Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil

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Célia R Nogueira Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil

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Edenir I Palmero Hospital de Câncer de Barretos, Barretos, São Paulo, Brazil
Faculdade de Ciências da Saúde de Barretos Dr. Paulo Prata, Barretos, São Paulo, Brazil

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Cencita H C N Pessoa Instituto Nacional do Câncer, Rio de Janeiro, Rio de Janeiro, Brazil

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Bibiana Prada Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, São Paulo, Brazil

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Débora R Siqueira Hospital de Clínicas de Porto Alegre and Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

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Maria Sharmila A Sousa Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
Escola Fiocruz de Governo, Fundação Oswaldo Cruz and Ministério da Saúde, Brasília, Distrito Federal, Brazil

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Rodrigo A Toledo Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
Vall d’Hebron Institute of Oncology (VHIO), CIBERONC, Barcelona, Spain

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Flávia O F Valente Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil

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Fernanda Vaisman Instituto Nacional do Câncer, Rio de Janeiro, Rio de Janeiro, Brazil

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Laura S Ward Faculdade de Ciências Médicas, Universidade de Campinas, Campinas, São Paulo, Brazil

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Shana S Weber Hospital de Clínicas de Porto Alegre and Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

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Rita V Weiss Instituto Estadual de Diabetes e Endocrinologia, Rio de Janeiro, Rio de Janeiro, Brazil

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Ji H Yang Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil

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Magnus R Dias-da-Silva Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil

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Ana O Hoff Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
Instituto do Câncer do Estado de São Paulo, São Paulo, São Paulo, Brazil

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Sergio P A Toledo Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil

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Ana L Maia Hospital de Clínicas de Porto Alegre and Faculdade de Medicina da Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

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Brazilian centers involved in the diagnosis and treatment of thyroid cancer. Declaration of interest The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported

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Rasmus Reinke Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark

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Stefano Christian Londero Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark

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Martin Almquist Department of Surgery, Lund University Hospital, Lund, Sweden

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Lars Rejnmark Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark

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Lars Rolighed Department of Otorhinolaryngology, Head and Neck Surgery, Aarhus University Hospital, Aarhus, Denmark

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differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer . Thyroid 2016 26 1 – 133 . ( https://doi.org/10.1089/thy.2015.0020 ) 25 McWade MA Sanders ME Broome JT Solorzano

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Adrian F Daly Department of Endocrinology, Centre Hospitalier Universitaire (CHU) de Liège, Liège Université, Domaine Universitaire du Sart-Tilman, Liège, Belgium

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Liliya Rostomyan Department of Endocrinology, Centre Hospitalier Universitaire (CHU) de Liège, Liège Université, Domaine Universitaire du Sart-Tilman, Liège, Belgium

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Daniela Betea Department of Endocrinology, Centre Hospitalier Universitaire (CHU) de Liège, Liège Université, Domaine Universitaire du Sart-Tilman, Liège, Belgium

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Jean-François Bonneville Department of Endocrinology, Centre Hospitalier Universitaire (CHU) de Liège, Liège Université, Domaine Universitaire du Sart-Tilman, Liège, Belgium

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Chiara Villa Department of Endocrinology, Centre Hospitalier Universitaire (CHU) de Liège, Liège Université, Domaine Universitaire du Sart-Tilman, Liège, Belgium
Department of Pathological Cytology and Anatomy, Foch Hospital, Paris, France

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Natalia S Pellegata Institute for Diabetes and Cancer, Helmholtz Zentrum München, Neuherberg, Germany

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Beatrice Waser Division of Cell Biology and Experimental Cancer Research, Institute of Pathology, University of Bern, Bern, Switzerland

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Jean-Claude Reubi Division of Cell Biology and Experimental Cancer Research, Institute of Pathology, University of Bern, Bern, Switzerland

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Catherine Waeber Stephan Clinique Générale Ste-Anne, Fribourg, Switzerland

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Emanuel Christ Department of Endocrinology, Diabetology and Metabolism, University Hospital Basel, University of Basel, Basel, Switzerland

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Albert Beckers Department of Endocrinology, Centre Hospitalier Universitaire (CHU) de Liège, Liège Université, Domaine Universitaire du Sart-Tilman, Liège, Belgium

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, which was performed under an approval of the Ethics Committee of the Centre Hospitalier Universitaire de Liège. Immunohistochemistry AIP immunostaining of paraffin preserved tumor tissue (pituitary in Patient 2 and thyroid cancer in the sister of

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Dario de Biase Department of Pharmacy and Biotechnology (Dipartimento di Farmacia e Biotecnologie) – Molecular Diagnostic Unit, Azienda USL di Bologna, University of Bologna, Bologna, Italy

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Federica Torricelli Laboratory of Translational Research, Azienda Unità Sanitaria Locale AUSL-IRCCS, Reggio Emilia, Italy

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Moira Ragazzi Pathology Unit, Azienda Unità Sanitaria Locale AUSL-IRCCS, Reggio Emilia, Italy

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Benedetta Donati Laboratory of Translational Research, Azienda Unità Sanitaria Locale AUSL-IRCCS, Reggio Emilia, Italy

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Elisabetta Kuhn Pathology Unit, Azienda Unità Sanitaria Locale AUSL-IRCCS, Reggio Emilia, Italy

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Michela Visani Department of Medicine (Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale) – Molecular Diagnostic Unit, Azienda USL di Bologna, University of Bologna School of Medicine, Bologna, Italy

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Giorgia Acquaviva Department of Medicine (Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale) – Molecular Diagnostic Unit, Azienda USL di Bologna, University of Bologna School of Medicine, Bologna, Italy

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Annalisa Pession Department of Pharmacy and Biotechnology (Dipartimento di Farmacia e Biotecnologie) – Molecular Diagnostic Unit, Azienda USL di Bologna, University of Bologna, Bologna, Italy

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Giovanni Tallini Department of Medicine (Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale) – Molecular Diagnostic Unit, Azienda USL di Bologna, University of Bologna School of Medicine, Bologna, Italy

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Simonetta Piana Pathology Unit, Azienda Unità Sanitaria Locale AUSL-IRCCS, Reggio Emilia, Italy

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Alessia Ciarrocchi Laboratory of Translational Research, Azienda Unità Sanitaria Locale AUSL-IRCCS, Reggio Emilia, Italy

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of thyroid cancer ( 3 ). It represents 1–2% of clinically recognized thyroid malignancies but it accounts for more than half of the deaths for thyroid cancer. Five-year survival rate for ATC patients is estimated below 1% and about 50% of ATC patients

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Luchuan Li Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China

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Baoyuan Li Department of Thyroid Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China

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Bin Lv Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China

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Weili Liang Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China

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Binbin Zhang Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China

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Qingdong Zeng Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China

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Andrew G Turner Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia

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Lei Sheng Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China

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( 8 , 9 ). Moreover, several authors have described a rate of thyroid cancer in patients with PHPT that appears to be higher than the general population ( 4 , 10 , 11 , 12 , 13 , 14 , 15 ). A review of data from nine studies, including a total

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T P McVeigh Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland

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R J Mulligan Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland

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U M McVeigh Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland

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P W Owens Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland

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N Miller Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland

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M Bell Department of Endocrinology, School of Medicine, NUI Galway, Galway, Ireland

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F Sebag Department of Endocrine Surgery Centre hospitalo-universitaire de La Conception, Assistance Publique Hôpitaux de Marseille, Marseille, France
Aix-Marseille Université, Faculté de Médecine, Marseille, France

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C Guerin Department of Endocrine Surgery Centre hospitalo-universitaire de La Conception, Assistance Publique Hôpitaux de Marseille, Marseille, France
Aix-Marseille Université, Faculté de Médecine, Marseille, France

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D S Quill Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland

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J B Weidhaas David Geffen School of Medicine, University of California, Los Angeles, USA

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M J Kerin Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland

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A J Lowery Discipline of Surgery, Lambe Institute for Translational Research, School of Medicine, NUI Galway, Galway, Ireland

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remained ill-defined. A recent meta-analysis has revisited the possibility of such an association and has confirmed the existence of, and quantified the increased co-occurrence of breast and differentiated thyroid cancer (DTC) ( 1 ). Both cancers occur

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Xu-Feng Chen Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China

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Cong He Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China

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Peng-Cheng Yu Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China

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Wei-Dong Ye Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China

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Pei-Zheng Han Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China

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Jia-Qian Hu Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China

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Yu-Long Wang Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People’s Republic of China

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clinical practice. NGS reveals the comprehensive genetic background of a certain tumor, thus assisting tumor diagnosis and treatment. Thyroid cancer is the most common endocrine malignancy with an increasing incidence ( 2 ) in recent decades. Exciting

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