Effectiveness of Peripheral Thyrotropin Receptor mRNA in Follow-Up of Differentiated Thyroid Cancer

Abstract

Thyroid cells in peripheral circulation have been linked to thyroid cancer (TC). These cells express thyrotropin receptor (TSHR) messenger RNA (mRNA), which has been studied as a marker of initial TC diagnosis. We examined the utility of TSHR mRNA in long-term follow-up of TC patients. From 2002 to 2007, TSHR mRNA was prospectively measured by quantitative reverse-transcription polymerase chain reaction (RT-PCR) from peripheral blood samples in 259 patients, and those followed > or =3 months since initial thyroidectomy were studied. TSHR mRNA levels were correlated to thyroglobulin (Tg), imaging studies, and disease status during follow-up. Thirty-four patients underwent 20 +/- 14 months median follow-up for papillary (n = 31, 91%), follicular (n = 2) or Hurthle cell (n = 1) TC. Advanced-stage disease occurred in 24% at presentation, and 11 (32%) developed cervical node metastases or recurrence requiring reoperation during follow-up. Of 52 simultaneous TSHR mRNA and serum Tg measurements, 52% were concordant. TSHR mRNA missed disease in 21% patients, but was better than Tg in 27%, including all those with Tg antibodies. TSHR mRNA concurred with whole-body scan detectable disease for 11/14 patients (79%) and accurately predicted overall TC disease status in 77% patients. In discordant cases, TC recurrence was apparent from other imaging modalities [positron emission tomography (PET) scan or ultrasound]. TSHR mRNA in conjunction with Tg diagnosed TC recurrence with 90% sensitivity and 94% specificity. We conclude that TSHR mRNA demonstrates high concordance rates with present methods of detecting TC recurrence, and appears to be more accurate in patients with Tg antibodies. As a novel adjunct, TSHR mRNA may enhance long-term management of TC patients.

Measurement of Calcitonin and Calcitonin Gene–Related Peptide mRNA Refines the Management of Patients with Medullary Thyroid Cancer and May Replace Calcitonin-Stimulation Tests

“…Herein, we have proposed an alternative tool that is similar to the one already in use in the management of differentiated thyroid cancer, using thyroglobulin and thyrotropin receptor mRNAs in the follow-up of patients who have tested positive for anti-thyroglobulin antibodies (47)(48)(49). In two previous studies, blood CT mRNA was detected by RT-PCR (50,51).…”

Circulating thyroid stimulating hormone receptor messenger RNA and differentiated thyroid cancer: A diagnostic meta-analysis

“…As a potential diagnostic biomarker for thyroid cancer, serum or plasma TSHR-mRNA is characterized by minimal invasion and convenience compared with FNA based histopathological examination. In addition, TSHR-mRNA could serve to monitor the disease recurrence after surgery [26]. …”

Serum markers for recurrence in patients with differentiated thyroid cancer after combined treatment and the retreatment results

“…У па циен тов с ДРЩЖ кон цен т ра ция АТ-ТГ в 2-3 ра за больше, чем в сред нем в по пу ля ции, что яв ля ет ся до полни тель ным мар ке ром за бо ле ва ния [16]. Ком плек сы АТ-ТГ по сле ра диой о даб ля ции мо гут пер си с ти ро вать в кро ви от 1 до 3 лет [17,18]. Им му но фер мент ным ана ли зом (ИФА) не все гда уда ет ся об на ру жить ТГ, вхо дя щий в со став АТ-ТГ, что при во дит к лож но отри ца тель ным ре зуль та там ис сле до ва ния.…”