We have recently identified in medullary thyroid carcinoma the existence of a second calcitonin messenger, generated by a splicing between the 3' coding region of exon 4 and exon 5 of Calc I gene. It differs from the first one in its 3' coding sequence and codes for a calcitonin precursor which generates the same N terminal peptide, calcitonin and a specific 21 amino acid carboxy terminal peptide differing from Katacalcin by its 8 last amino acids. We searched for the expression of this new messenger in normal human thyroid tissue by Northern and by polymerase chain reaction techniques. This second calcitonin messenger was expressed in 4/4 normal thyroids and 4/5 medullary thyroid carcinoma tissue samples. The expression of this second messenger is apparently a common occurrence in C cells whether normal or tumoral.

mRNAs were isolated from 2 patients suffering from a familial form of a rare variant of medullary carcinoma of the thyroid (MTC), called mixed follicular and medullary carcinoma. The presence of calcitonin (CT) and thyroglobulin (Tg) mRNAs was checked by northern and in situ hybridization and compared with immunohistochemical results. In each case, mRNAs hybridizing to probes specific for CT and Tg were detected. Both proteins were quantified by radioimmunoassay determination in tissue extracts. Patient 1 had 20 ng Tg and 68 ng CT per micrograms total protein, and patient 2 had 0.4 ng Tg and 1.7 ng CT per micrograms total protein. Northern analysis showed that mixed carcinoma expressed several species of both CT mRNAs and Tg mRNAs. The main Tg transcripts present in neoplastic cells (8.5 and 4.8 kb for patient 1 and patient 2) were identical to or smaller than those of normal thyroid tissue (8.5 kb). The tumor CT mRNA (1 kb) was identical to that of normal tissue. In situ hybridization confirmed the presence of CT and Tg mRNA in the great majority of tumor cells. Furthermore, the presence of small amounts of organified iodine was evidenced by analytical ion microscopy in 35% of these cells. This raises an important question regarding the histogenesis of this tumor.

Previous reports on human thyroglobulin (hTg) modifications in thyroid carcinomas prompted us to study hTg mRNA in thyroid adenomas and carcinomas. The quantification of hTg mRNA showed a decrease in its levels of expression in both pathological conditions which differed by a factor of 2 between adenomas and carcinomas. Furthermore, PCR was used to analyse the characteristics of hTg mRNA by amplifying 4 regions of the hTg mRNA. When applied to 2 normal, 17 benign and 13 malignant pathological tissue specimens, PCR showed no modification in the size of Tg mRNA. However, abnormal sized cDNAs appeared in all tissues with no distinction between the pathologies; the Restriction Fragment Length Polymorphism study of these cDNAs suggests the existence of alternate splicing patterns in thyroglobulin mRNAs.

The human calcitonin gene generates 2 distinct mature mRNAs by alternative RNA processing, encoding calcitonin (CT) in thyroid C-cells or a neuropeptide (CGRP) in the brain. We evaluated quantitatively by in situ hybridization the expression of the CT gene in tissue section of 5 MTCs (2 sporadic and 3 familial forms). The primary tumor of one MTC was compared to a brain metastasis. In situ hybridization was carried out with tritiated cDNA probes coding for CT and CGRP mRNA. After autoradiography the number of silver grains was conunted in 400 cells by computerized analysis of digitized images and expressed as the labelling level (L.L. = grain area/cell area per day of autoradiographic exposure). This was used to calculate the relative abundance per cell of the specific messengers studied, which depends on the autoradiographic efficiency and the specific activity of the probe used. The CT mRNA content was 3.25–6.55 10−10 μg equivalents in the 3 familial forms of MTC and 4.95–9.25 10−10 μg equivalents for the 2 sporadic forms. The levels of CT mRNA in the brain metastasis and in the primary tumor were identical (4.10 10−10 μg equivalents). CGRP mRNA expression was weaker in the sporadic and in the familial thyroid tumors (0.60–1.65 10−10 μg equivalents). The content of mRNA CGRP in the brain metastasis (0.60 10~10 /xg equivalents) was lower than that in the primary tumor (1.05 10−10 μg equivalents). These results suggest that most of the primary RNA transcript generated by CT gene lead to the formation of CT mRNA in MTC, and the alternative mRNA processing pathway in sporadic and familial forms does not seem to be different. No correlation was found between the amount of tumor CT mRNA and clinical course of the MTC. The latter appears to be more linked to the initial extent of the disease.

Analytical ion microscopy (AIM) can be used for imaging and relative quantification of chemical elements in tissue sections. We used this technique to assess the changes in 127I mapping within thyroid follicular cells and follicular lumina in benign thyroid epithelial abnormalities from 17 patients and in macroscopically normal perinodular tissue surrounding solitary cold nodules from 8 patients. Among the 17 patients, 9 had simple goiters, 5 had toxic nodular goiters, and 3 had hypofunctioning (cold) nodules. The tissue samples were fixed chemically and embedded in methacrylate resin to ensure preservation of organified iodine, and thin sections were analyzed by AIM. 127I was found in the follicular lumina and follicular epithelial cells of most specimens. The local concentration of 127I, which is proportional to the ratio of the two secondary ion beam currents of iodine and carbon, was evaluated in 30 follicular lumina and 30 follicular epithelial cells of each specimen. In normal tissue, the relative 127I concentration within follicular cells (mean, 0.72; range 0.01-8.30) was much lower than that in follicular lumina (mean, 4.63; range, 0.18-36.74). In simple goiter tissue, follicular lumen (mean, 0.57; range, 0.00-5.76), and cell (mean, 0.17; range, 0.002-1.82) relative 127I concentrations were below normal, but both distributions remained different. On the contrary, in toxic nodular goiter tissue the follicular cell relative 127I concentration (mean, 0.96; range, 0.003-27.3) largely overlapped that of the follicular lumina (mean, 2.1; range, 0.001-36.5). The cold nodules had the lowest relative follicular lumina 127I concentration (mean, 0.008; range, undetectable-0.07), and the relative cellular 127I concentrations were undetectable in 67%. These results demonstrate the capacity of AIM to characterize the functional activity of thyroid tissue without prior administration of radio-iodine.

Calcitonin mRNA was detected in human medullary carcinoma using an in situ hybridization technique. This specific and reproducible method could lead to a better functional characterization of medullary carcinoma and should allow the definition of new prognosis factors in medullary thyroid cancer.