Immunohistochemical study of epidermal growth factor (EGF), epidermal growth factor receptor (EGFR) and transforming growth factor-alpha (TGF-alpha) expression was performed on paraffin-embedded tissue specimens of 12 follicular carcinomas, 15 papillary carcinomas and 15 adenomas of the thyroid gland. The tumors were placed in one of the following eight groups, according to the results of EGF, TGF-alpha and EGFR expression: group 1: none, group 2: only EGFR, group 3: EGFR and TGF-alpha, group 4: EGFR and EGF, group 5: TGF-alpha, and EGF, group 6: all three, group 7: only TFG-alpha and, finally, group 8: only EGF. Statistical analysis of the results revealed that the ratio of thyroid carcinomas with lymph node metastasis was significantly higher in groups 3 and 6 for follicular carcinomas (P less than 0.01) and in groups 4, 5 and 6 for papillary carcinomas (P less than 0.01). These results suggest that thyroid carcinomas expressing the systems EGF/EGFR, TGF-alpha/EGFR or TGF-alpha/EGF/EGFR display pathologic features of more aggressive disease. Furthermore, the synchronous expression of EGF, TGF-alpha and EGFR indicates that these carcinomas may regulate their growth by an autocrine and/or paracrine mechanism.