Expression of NUCB 2 in medullar thyroid cancer and its relationship with clinicopathological findings

Nucleobindin-2 and its active metabolic product nefsatin-1; with its rich molecular structure, it plays a role in many functions such as energy homeostasis, insulin release, adipocyte differentiation, myocardial functioning and tumor behavior. In recent years, studies have shown that increased nefsatin-1 expression increases cancer progression, especially in breast, colon, prostate, endometrium, thyroid, bladder cancers or glioblastoma. It has been observed that it reduces adrenocortical carcinoma and ovarian epithelial carcinoma. No study has been found in the literature regarding the relationship between medullary thyroid cancer and Nucleobindin-2 protein. In our study, the data of 25 patients diagnosed in the Endocrinology department of Trakya University Faculty of Medicine between 2002 and 2023 were examined. Pathology preparations were stained immunohistochemically with Nucleobindin-2. Data were reclassified according to the medullary thyroid carcinoma grading system recommended by current guidelines. In our study, the preparations of all 25 patients were stained with Nucleobindin-2 antigen and the results were examined in two separate groups according to both percentage and staining strength. No statistically significant relationship was found between the clinical- genetic-pathological data of the patients and Nucleobindin-2. Contrary to many studies, it was found that nucleobindin-2 protein expression was not correlated with poor prognostic criteria of the tumor. Due to the early lesion detection, successful operation rates, and close follow-up of most of our patients, progression-free and overall survival analyzes could not be calculated clearly. No significant relationship was found between poor prognostic factors and WHO 22 classification, TNM staging, calcitonin and carcinoembryonic antigen doubling times, and tumor size. Even if patients are followed closely, detailed imaging, and regular examination of biochemical parameters are ensured, the clinical course of cancer may not be predictable. The diagnostic methods we have are still not sufficient to clarify the course of the disease. There is a need for many more methods, including nucleobindin-2, that can be used to understand the course of the disease and as a prognostic factor. Key Words: Medullary thyroid cancer, Nucleobindin-2, WHO 22 classifi