Abstract
Thyroid nodules are a very common problem. Since malignant thyroid nodules should be treated surgically, preoperative diagnosis of thyroid cancer is very crucial. Cytopathologic analysis of percutaneous fine-needle aspiration (FNA) specimens is the current gold standard for diagnosing thyroid nodules. However, this method has led to high rates of inconclusive results. Metabolomics has emerged as a useful tool in medical fields and shown great potential in diagnosing various cancers. Here, we evaluated the potential of nuclear magnetic resonance (NMR) analysis of percutaneous FNA specimens for preoperative diagnosis of thyroid cancer. We analyzed metabolome of FNA samples of papillary thyroid carcinoma (n = 35) and benign follicular nodule (n = 69) using a proton NMR spectrometer. The metabolomic profiles showed a considerable discrimination between benign and malignant nodules. Receiver operating characteristic (ROC) curve analysis indicated that seven metabolites could serve as discriminators (area under ROC curve value, 0.64–0.85). These findings demonstrated that NMR analysis of percutaneous FNA specimens of thyroid nodules can be potentially useful in the accurate and rapid preoperative diagnosis of thyroid cancer.
Highlights
Due to the limitations of conventional cytopathologic analysis, several molecular analyses have been assessed and reported to have some potential as adjuncts to conventional cytopathologic analysis[11,12,13,14]
Among a total of 230 percutaneous fine-needle aspiration (FNA) samples, 85 were benign and 53 were malignant based on cytopathologic analyses according to the Bethesda system[5] (Fig. 1)
The current study enrolled the largest number of thyroid nodules for nuclear magnetic resonance (NMR) analysis
Summary
Due to the limitations of conventional cytopathologic analysis, several molecular analyses have been assessed and reported to have some potential as adjuncts to conventional cytopathologic analysis[11,12,13,14]. Metabolomics has emerged as a useful tool in multiple medical fields. It has shown great potential in diagnosing various cancers, such as breast, prostate, and colorectal cancers[15,16,17,18,19,20]. The previous studies did not test the metabolomic approach as a preoperative diagnostic tool for thyroid nodules[21,22,23,24,25,26,27]. The purpose of this study was to evaluate the potential of nuclear magnetic resonance (NMR) analysis of percutaneous FNA specimens for preoperative diagnosis of thyroid cancer
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