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

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