Clinical Science
Evaluation of genetic biomarkers for distinguishing benign from malignant thyroid neoplasms

https://doi.org/10.1016/j.amjsurg.2013.06.012Get rights and content

Abstract

Background

Fine-needle aspiration (FNA) aids in the diagnosis of thyroid nodules. The expression of previously implicated genes was examined to potentially discriminate between benign and malignant thyroid samples.

Methods

Patients included for study had cytology demonstrating follicular cells of undetermined significance, atypical cells of undetermined significance, follicular neoplasm, or suspicion of malignancy with one of the following postoperative diagnoses: follicular thyroid adenomas, follicular thyroid carcinomas, or follicular variant of papillary thyroid carcinomas (FV-PTCs). FNA and tumor expression of human telomerase reverse transcriptase (hTERT), high-mobility group A2 (HMGA2), and trefoil factor 3/3-galactoside-binding lectin (T/G ratio) were analyzed.

Results

T/G ratios were not significantly different in the malignant and benign groups. HMGA2 was overexpressed in carcinoma states; however, only FV-PTCs were significant (P = .006). Tumor hTERT expression was detected in 25% of follicular thyroid carcinomas, whereas 5% of FV-PTCs and 10% of follicular thyroid adenomas had expression. FNA aspirates showed similar results.

Conclusions

Although HMGA2 and hTERT showed differential expression, they did not consistently differentiate benign from malignant. Further study based on global gene expression is needed to identify markers that could serve as a diagnostic tool.

Section snippets

Patients and Methods

The study was approved by our institutional review board, and consent was obtained from all patients before testing. From October 2009 to June 2011, we included in our study all consecutive patients with thyroid nodules showing a follicular lesion of undetermined significance or atypical cells on undetermined significance, follicular neoplasm, and suspicion for malignancy with one of the following postoperative pathologies: follicular or Hürthle cell adenoma, follicular or Hürthle cell

Demographic data

A total of 52 patients were included in this study: 21 had FTAs, 12 had FTCs, and 19 had FV-PTCs on postoperative pathology. Women constituted the majority of patients in all groups (83%), and the mean age in years of the entire group was 53.3. A history of previous cancers, family history of thyroid disease, and history of hypo-/hyperthyroidism were similar between groups. Patients with a diagnosis of carcinoma on FNA were more likely to undergo total thyroidectomy or lobectomy with completion

Comments

FNA is essential in the workup of a thyroid nodule.1, 2 However, there are limitations of this technique's diagnostic capability for follicular lesions. The primary aim of this study was to validate specific genetic markers already established in the literature as possible biomarkers of thyroid malignancy and to distinguish between benign and malignant follicular thyroid disease in FNA specimens. Genetic markers have been identified as possible markers for FTC, but the methodologies are limited

References (18)

There are more references available in the full text version of this article.

Cited by (0)

The authors declare no conflict of interest.

View full text