The utility of peripheral thyrotropin mRNA in the diagnosis of follicular neoplasms and surveillance of thyroid cancers

Kresimira Milas, Peter Mazzaglia, Su Ynn Chia, Mario Skugor, Eren Berber, Sethu Reddy, Manjula Gupta, Allan Siperstein

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: Thyroid cells in peripheral circulation express uniquely thyrotropin receptor (TSHR) mRNA, and their detection may aid thyroid cancer management. Methods: Since 2002, 258 patients had prospective TSHR mRNA measurement by quantitative RT-PCR from peripheral blood before and/or after thyroidectomy. Thyroid cancer detection was assessed from known clinical diagnostic criteria and mRNA for patients with follicular neoplasms (n = 64) and long-term cancer follow-up (n = 13). Results: Adding TSHR mRNA to fine-needle aspiration biopsy (FNAB) maintained high sensitivity (90%) but improved specificity (73%) for thyroid cancer diagnosis. When FNAB specimens indicated follicular neoplasm, a decision algorithm combining TSHR mRNA and abnormal thyroid ultrasound features correctly diagnosed all cancer patients (100% sensitivity) and would have spared operation for benign disease in 38%. Elevated TSHR mRNA on postoperative day1 predicted persistent/recurrent cancer. During long-term thyroid cancer surveillance, TSHR mRNA had a 91% concordance with radioactive iodine whole body scan (WBS)-detectable disease, agreed with thyroglobulin (Tg) levels in 64% of patents, missed disease in 5%, but was more sensitive to detecting disease than Tg levels in 31% of patients, including all patients with Tg antibodies. Conclusions: Detecting circulating thyroid cancer cells is useful for initial thyroid cancer diagnosis and postoperatively predicts recurrent cancer. This novel test promises to enhance thyroid cancer patient care by management algorithms that combine histologic, genomic, and clinical criteria.

Original languageEnglish (US)
Pages (from-to)137-146
Number of pages10
JournalSurgery
Volume141
Issue number2
DOIs
StatePublished - Feb 2007
Externally publishedYes

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Thyrotropin
Thyroid Neoplasms
Messenger RNA
Thyroglobulin
Neoplasms
Fine Needle Biopsy
Thyroid Gland
Patient Care Management
Whole Body Imaging
Thyrotropin Receptors
Patents
Thyroidectomy
Iodine
Polymerase Chain Reaction
Antibodies

ASJC Scopus subject areas

  • Surgery

Cite this

Milas, K., Mazzaglia, P., Chia, S. Y., Skugor, M., Berber, E., Reddy, S., ... Siperstein, A. (2007). The utility of peripheral thyrotropin mRNA in the diagnosis of follicular neoplasms and surveillance of thyroid cancers. Surgery, 141(2), 137-146. https://doi.org/10.1016/j.surg.2006.12.002

The utility of peripheral thyrotropin mRNA in the diagnosis of follicular neoplasms and surveillance of thyroid cancers. / Milas, Kresimira; Mazzaglia, Peter; Chia, Su Ynn; Skugor, Mario; Berber, Eren; Reddy, Sethu; Gupta, Manjula; Siperstein, Allan.

In: Surgery, Vol. 141, No. 2, 02.2007, p. 137-146.

Research output: Contribution to journalArticle

Milas, K, Mazzaglia, P, Chia, SY, Skugor, M, Berber, E, Reddy, S, Gupta, M & Siperstein, A 2007, 'The utility of peripheral thyrotropin mRNA in the diagnosis of follicular neoplasms and surveillance of thyroid cancers', Surgery, vol. 141, no. 2, pp. 137-146. https://doi.org/10.1016/j.surg.2006.12.002
Milas, Kresimira ; Mazzaglia, Peter ; Chia, Su Ynn ; Skugor, Mario ; Berber, Eren ; Reddy, Sethu ; Gupta, Manjula ; Siperstein, Allan. / The utility of peripheral thyrotropin mRNA in the diagnosis of follicular neoplasms and surveillance of thyroid cancers. In: Surgery. 2007 ; Vol. 141, No. 2. pp. 137-146.
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