Correlation of thyroid stimulating hormone receptor mRNA expression levels in peripheral blood with undesirable clinicopathological features in papillary thyroid carcinoma patients.

Riming Liu,Xincheng Liu,Xin Liu,Shaolong Hao,Jihong Ma,Xicheng Song,Lixin Jiang,Hua Zhang,Jie Xu,Guojun Li,Haitao Zheng,Yan Sun,Jinyao Ning

doi:10.18632/oncotarget.18273

Abstract

To determine the extent to which thyroid stimulating hormone receptor (TSHR) mRNA in peripheral blood (PB) has diagnostic value for papillary thyroid carcinoma (PTC). We obtained pre- and postoperative PB samples from 104 thyroid disease patients and collected 11 healthy volunteers’ PB samples twice apiece at different times. We used reverse transcription polymerase chain reaction (RT-PCR) to quantify TSHR mRNA expression levels in the samples. T-test and chi-square test were used to compare quantitative data and rates. The mean preoperative PB TSHR mRNA expression level of the PTC patients was significantly higher than that of the healthy volunteers. However, on the postoperative day 1, PB TSHR mRNA level of PTC patients significantly decreased but not for healthy controls. Preoperative PB TSHR mRNA expression levels were significantly associated with patient age, capsular invasion status, lymph node metastasis status, and BRAFV600E mutation status (P < 0.05) but not gender, tumor size, number of cancer foci, or Hashimoto thyroiditis status. Preoperative assessment of the PB TSHR mRNA expression level combined with ultrasonography of the thyroid had better accuracy in the diagnosis of PTC than either method alone did. Moreover, TSHR mRNA expression significantly affected recurrence of PTC patients. Our findings suggest that PB TSHR mRNA expression level is a promising novel biomarker for the early detection, diagnosis, and treatment of PTC. It may serve as a noninvasive means of PTC detection and a prognostic biomarker of residual tumor and help guide further treatment.

Highlights

The incidence of papillary thyroid carcinoma (PTC), the most common endocrine malignancy, has risen rapidly in recent decades owing to widespread environmental and dietary changes and an increasing rate of thyroid papillary microcarcinoma (PTMC) [1]
In 2004, Chinnappa et al found that thyroid cancer patients had a higher rate of thyroid stimulating hormone receptor (TSHR) mRNA expression in the peripheral blood (PB) than normal thyroid did [14]
Wagner et al [15], using RTPCR to detect TSHR mRNA in the PB of patients with benign or malignant thyroid nodules, found that patients with differentiated thyroid carcinoma had a higher level of TSHR mRNA expression in the PB than benign thyroid nodules did

Summary

Introduction

The incidence of papillary thyroid carcinoma (PTC), the most common endocrine malignancy, has risen rapidly in recent decades owing to widespread environmental and dietary changes and an increasing rate of thyroid papillary microcarcinoma (PTMC) [1]. The preoperative diagnosis of PTC is made primarily with thyroid ultrasonography and/or fine needle aspiration biopsy (FNAB) cytology. Both methods have limitations in the diagnosis of PTC. Improvements in ultrasonography have increased the rate of accurate diagnosis of patients with thyroid disease, some cases are still difficult to identify with thyroid ultrasonography alone, leading to misdiagnoses that have negatively influenced patients’ prognosis and treatment. FNAB cytology is invasive, and its rate of clinical application in many hospitals in China had been considerably low until recently; in addition, FNAB cytology has false positive and false negative rates of about 5% each, which have contributed to misdiagnoses in 10%–30% of suspected PTC cases [2]. A new test for the diagnosis of PTC is necessary

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