We performed immunohistochemistry to measure COMP levels in PTC tissues and adjacent normal tissues. In total, 58 pairs of PTC tissue and matched adjacent normal tissue sections were procured from Shanghai Outdo Biotech Co, Ltd. (Shanghai, China) embedded in paraffin, and incubated with anti-COMP antibody (ab11056, Abcam, Cambridge, UK; 1:1000 dilution). Samples were selected at Shanghai Outdo Biotech Co, Ltd between 2004 and 2012. Inclusion criteria: complete patient case data; no other systemic malignancy. Exclusion criteria: unqualified; non-self-matched samples; preoperative radiotherapy and chemotherapy. The study was approved by the regional ethics committee at Taizhou hospital of Zhejiang province. Two pathologists performed double-blinded slide reading with no prior knowledge of tumor grade. For every tissue section, COMP staining was observed from ten different fields of vision under a microscope, and was scored based on the percentage of positive cells and staining intensity. The percentages of stained cells among the total number of cells were scored as follows: < 5% (0 points), 5%-25% (1 point), 26%-50% (2 points), 51%-75% (3 points), and >75% (4 points). Staining intensity was scored as: not stained (0 points), light yellow (1 point), yellow-brown (2 points), and dark brown (3 points). The final staining score was obtained by multiplying these two scores, and the results were categorized as: negative (0 points), weak-positive (1-4 points), positive (5-8 points), and strong positive (9-12 points).

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