Abstract
Thyroid cancer is the most common endocrine system malignancy. However, there is still a lack of reliable and specific markers for the detection and staging of this disease. Fine needle aspiration biopsy is the current gold standard for diagnosis of thyroid cancer, but drawbacks to this technique include indeterminate results or an inability to discriminate different carcinomas, thereby requiring additional surgical procedures to obtain a final diagnosis. It is, therefore, necessary to seek more reliable markers to complement and improve current methods. “Omics” approaches have gained much attention in the last decade in the field of biomarker discovery for diagnostic and prognostic characterisation of various pathophysiological conditions. Metabolomics, in particular, has the potential to identify molecular markers of thyroid cancer and identify novel metabolic profiles of the disease, which can, in turn, help in the classification of pathological conditions and lead to a more personalised therapy, assisting in the diagnosis and in the prediction of cancer behaviour. This review considers the current results in thyroid cancer biomarker research with a focus on metabolomics.
Highlights
Thyroid carcinoma is the most common endocrine malignancy with papillary thyroid carcinoma accounting for 85–90% of all thyroid tumours [1,2,3]
The first high-resolution magic angle spinning (HR-MAS) nuclear magnetic resonance (NMR) metabolomics study [51] and the first mass spectrometry (MS) study [52] that we found in our literature search were both published in 2011
The need for reliable biomarkers that can be used for fast and accurate diagnosis of the disease is critical since the initial cytological diagnostic evaluation via fine-needle aspiration biopsy (FNAB) often provides indeterminate results and distinguishing between different types of thyroid nodules is uncertain
Summary
Thyroid carcinoma is the most common endocrine malignancy with papillary thyroid carcinoma accounting for 85–90% of all thyroid tumours [1,2,3]. In terms of genetic biomarkers, the BRAFV600E mutation has been found to be very specific for papillary thyroid carcinoma; its absence cannot reliably rule it out [11,14] These common genetic mutations are considered poor prognostic markers, they can still be useful at an individual level [15]. A proteomics profiling of tissues for the four types of thyroid cancer and benign follicular adenoma revealed that several proteins associated with metabolism, including mitochondria-related functions, lipid and nucleic acids metabolism, could discriminate between these different thyroid lesions [25]. As metabolites are the end-products of biochemical reactions in the body, they are the closest molecules to phenotype On this basis, metabolomics could represent a very useful tool for the identification of metabolic pathways specific to thyroid cancer, alongside other omics techniques. We discuss how metabolomics has been used to study thyroid cancer by focusing on the original papers in the matter and suggest future perspectives
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