Effectiveness of peripheral thyrotropin receptor mRNA in follow-up of differentiated thyroid cancer

Kresimira Milas, German F. Barbosa, Jamie Mitchell, Eren Berber, Allan Siperstein, Manjula Gupta

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Thyroid cells in peripheral circulation have been linked to thyroid cancer (TC). These cells express thyrotropin receptor (TSHR) messenger RNA (mRNA), which has been studied as a marker of initial TC diagnosis. We examined the utility of TSHR mRNA in long-term follow-up of TC patients. From 2002 to 2007, TSHR mRNA was prospectively measured by quantitative reverse-transcription polymerase chain reaction (RT-PCR) from peripheral blood samples in 259 patients, and those followed 3 months since initial thyroidectomy were studied. TSHR mRNA levels were correlated to thyroglobulin (Tg), imaging studies, and disease status during follow-up. Thirty-four patients underwent 20 ± 14 months median follow-up for papillary (n = 31, 91%), follicular (n = 2) or Hurthle cell (n = 1) TC. Advanced-stage disease occurred in 24% at presentation, and 11 (32%) developed cervical node metastases or recurrence requiring reoperation during follow-up. Of 52 simultaneous TSHR mRNA and serum Tg measurements, 52% were concordant. TSHR mRNA missed disease in 21% patients, but was better than Tg in 27%, including all those with Tg antibodies. TSHR mRNA concurred with whole-body scan detectable disease for 11/14 patients (79%) and accurately predicted overall TC disease status in 77% patients. In discordant cases, TC recurrence was apparent from other imaging modalities [positron emission tomography (PET) scan or ultrasound]. TSHR mRNA in conjunction with Tg diagnosed TC recurrence with 90% sensitivity and 94% specificity. We conclude that TSHR mRNA demonstrates high concordance rates with present methods of detecting TC recurrence, and appears to be more accurate in patients with Tg antibodies. As a novel adjunct, TSHR mRNA may enhance long-term management of TC patients.

Original languageEnglish (US)
Pages (from-to)473-480
Number of pages8
JournalAnnals of Surgical Oncology
Volume16
Issue number2
DOIs
StatePublished - Feb 2009
Externally publishedYes

Fingerprint

Thyrotropin Receptors
Thyroid Neoplasms
Thyroglobulin
Messenger RNA
Recurrence
Oxyphil Cells
Whole Body Imaging
Antibodies
Thyroid Diseases
Thyroidectomy
Reoperation
Positron-Emission Tomography
Reverse Transcription
Thyroid Gland
Neoplasm Metastasis
Sensitivity and Specificity

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Effectiveness of peripheral thyrotropin receptor mRNA in follow-up of differentiated thyroid cancer. / Milas, Kresimira; Barbosa, German F.; Mitchell, Jamie; Berber, Eren; Siperstein, Allan; Gupta, Manjula.

In: Annals of Surgical Oncology, Vol. 16, No. 2, 02.2009, p. 473-480.

Research output: Contribution to journalArticle

Milas, K, Barbosa, GF, Mitchell, J, Berber, E, Siperstein, A & Gupta, M 2009, 'Effectiveness of peripheral thyrotropin receptor mRNA in follow-up of differentiated thyroid cancer', Annals of Surgical Oncology, vol. 16, no. 2, pp. 473-480. https://doi.org/10.1245/s10434-008-0211-9
Milas, Kresimira ; Barbosa, German F. ; Mitchell, Jamie ; Berber, Eren ; Siperstein, Allan ; Gupta, Manjula. / Effectiveness of peripheral thyrotropin receptor mRNA in follow-up of differentiated thyroid cancer. In: Annals of Surgical Oncology. 2009 ; Vol. 16, No. 2. pp. 473-480.
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abstract = "Thyroid cells in peripheral circulation have been linked to thyroid cancer (TC). These cells express thyrotropin receptor (TSHR) messenger RNA (mRNA), which has been studied as a marker of initial TC diagnosis. We examined the utility of TSHR mRNA in long-term follow-up of TC patients. From 2002 to 2007, TSHR mRNA was prospectively measured by quantitative reverse-transcription polymerase chain reaction (RT-PCR) from peripheral blood samples in 259 patients, and those followed 3 months since initial thyroidectomy were studied. TSHR mRNA levels were correlated to thyroglobulin (Tg), imaging studies, and disease status during follow-up. Thirty-four patients underwent 20 ± 14 months median follow-up for papillary (n = 31, 91{\%}), follicular (n = 2) or Hurthle cell (n = 1) TC. Advanced-stage disease occurred in 24{\%} at presentation, and 11 (32{\%}) developed cervical node metastases or recurrence requiring reoperation during follow-up. Of 52 simultaneous TSHR mRNA and serum Tg measurements, 52{\%} were concordant. TSHR mRNA missed disease in 21{\%} patients, but was better than Tg in 27{\%}, including all those with Tg antibodies. TSHR mRNA concurred with whole-body scan detectable disease for 11/14 patients (79{\%}) and accurately predicted overall TC disease status in 77{\%} patients. In discordant cases, TC recurrence was apparent from other imaging modalities [positron emission tomography (PET) scan or ultrasound]. TSHR mRNA in conjunction with Tg diagnosed TC recurrence with 90{\%} sensitivity and 94{\%} specificity. We conclude that TSHR mRNA demonstrates high concordance rates with present methods of detecting TC recurrence, and appears to be more accurate in patients with Tg antibodies. As a novel adjunct, TSHR mRNA may enhance long-term management of TC patients.",
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