Abstract
Preoperative diagnosis of thyroid nodules reduces unnecessary surgery. Circulating tumor cells (CTCs) may contain information of primary tumor(s). We asked whether the peripheral blood expression of genes specific for circulating tumor cells (CTCs) differentiates benign thyroid nodules from malignant nodules. Peripheral blood mononuclear cells from thyroid nodule patients (n = 20) were isolated preoperatively and the expression of seven CTC-associated genes was measured in patients with thyroid nodule(s) (n = 20). Among the tested genes, the expression of SLC5A5 and LGALS3 were validated in a larger number of patients (n = 64) and our results show that SLC5A5 expression differentiated follicular adenomas from follicular carcinomas (area under the curve (AUC) = 0.831). The expression of SLC5A5 in CTCs may preoperatively distinguish thyroid follicular adenomas from follicular carcinomas.
Highlights
Palpable thyroid nodules are found in roughly 5% of women and in 1% of men [1,2]
Measurement of TSHR mRNA expression in circulating tumor cells (CTCs) in the peripheral blood can distinguish malignant thyroid nodules from benign nodules, it is used in clinical settings [12]
peripheral blood mononuclear cells (PBMCs) samples from pathologically classified patients with thyroid nodules matched by gender, age, and tumor size, were selected retrospectively
Summary
Palpable thyroid nodules are found in roughly 5% of women and in 1% of men [1,2]. Measurement of TSHR mRNA expression in circulating tumor cells (CTCs) in the peripheral blood can distinguish malignant thyroid nodules from benign nodules, it is used in clinical settings [12]. TSHR is a well-known thyroid-specific/abundant gene used clinically as a blood biomarker of thyroid carcinoma [12]. GDF15, PCSK2, and CCND2 are three-gene combinatorial biomarkers, the combined expression of which is proposed to distinguish benign from malignant thyroid nodules in FNAB aspirates [17]. LGALS3 expression in thyroid tumors is higher than that in normal thyrocytes [21] This gene is expressed by blood cells, a systemic increase in its protein product is reported in cancer patients [22]; it was included in the study. We demonstrate that the expression of SLC5A5 distinguishes benign thyroid nodules from follicular subtype malignant nodules
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