Circulating thyrotropin receptor messenger ribonucleic acid is not an effective marker in the follow-up of differentiated thyroid carcinoma.

Surasawadee Ausavarat,Wanna Thongnoppakhun,Chaveevan Pattanachak,Rujaporn Chanachai,Aunchalee Laipiriyakun,Jiraporn Sriprapaporn,Boontham Amornkitticharoen,Busara Satayaban

doi:10.1186/s13044-015-0024-4

Surasawadee Ausavarat, Wanna Thongnoppakhun + Show 6 more

Open Access

https://doi.org/10.1186/s13044-015-0024-4

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Journal: Thyroid Research	Publication Date: Aug 4, 2015
Citations: 22	License type: CC BY 4.0

Affiliation: Siriraj Hospital, Mahidol University

Abstract

BackgroundCirculating thyrotropin receptor messenger ribonucleic acid (TSHR mRNA) assay has been validated in the follow-up of differentiated thyroid carcinoma (DTC) because of its high sensitivity during thyroid hormone therapy and no interference with endogenous anti-thyroglobulin antibodies (TgAb) compared to serum thyroglobulin (Tg). We investigated the efficacy of TSHR mRNA assay in 160 DTC patients using quantitative PCR (qPCR).FindingsOnly TSHR mRNA level of structural persistent disease with TgAb-positive (3.47 (2.97–9.53) pg equivalents/μg total RNA; p = 0.013) and its subgroup of distant metastasis patients with TgAb-positive (5.55 (3.28–12.52) pg equivalents/μg total RNA; p = 0.009) were significantly different from patients with no evidence of disease (2.32 (1.44–3.94) pg equivalents/μg total RNA). Applying cutoff at 2.00 pg equivalents/μg total RNA enabled us to predict structural persistent disease patients with a sensitivity of 62.3 % and a specificity of 42.9 %. Although, the sensitivity of TSHR mRNA assay in TgAb-postive patients (88.2 %) was superior than serum Tg (47.1 %) (p = 0.00002), the accuracy of the test is only 54.5 %.ConclusionsThis study demonstrated that TSHR mRNA assay has good sensitivity in TgAb-positive patients but it is neither specific enough as a first-line of testing nor a surrogate marker in the follow-up of our DTC patients.

Highlights

Circulating thyrotropin receptor messenger ribonucleic acid (TSHR mRNA) assay has been validated in the follow-up of differentiated thyroid carcinoma (DTC) because of its high sensitivity during thyroid hormone therapy and no interference with endogenous anti-thyroglobulin antibodies (TgAb) compared to serum thyroglobulin (Tg)
This study demonstrated that TSHR mRNA assay has good sensitivity in TgAb-positive patients but it is neither specific enough as a first-line of testing nor a surrogate marker in the follow-up of our DTC patients
We had demonstrated that only TSHR mRNA level of structural persistent disease and its subgroup of distant metastasis patients with TgAb-positive were significantly different from No evidence of disease (NED)

Summary

Introduction

Serum thyroglobulin (Tg) is widely accepted as a specific tumor marker for detection of residual, recurrence, or metastatic disease in the follow-up of patients with DTC after total thyroidectomy and ablative radioiodine therapy [1]. The study on efficacy of Tg mRNA in circulation as a novel tumor marker for DTC was first reported in 1966 by Ditkoff BA, et al [3]. The most comprehensive study is from Cleveland Clinic which determined the TSHR mRNA in monitoring of DTC and extended to benign thyroid diseases [13]. The study has shown so much promise that, nowadays, it has been introduced into routine clinical practice as a surrogate marker for circulating thyroid cells. We quantify TSHR mRNA by employing qPCR and evaluate the efficacy of TSHR mRNA in the follow-up of 160 patients with DTC

Patients and methods

Results

Conclusions