Thyroid nodules are common; fine-needle aspirations commonly are read as indeterminate, necessitating surgery to exclude carcinoma. We developed a 6-gene array-based predictor model to diagnose benign versus malignant thyroid lesions. In this study, we verified whether quantitative reverse transcription-polymerase chain reaction (qRT-PCR) using this model reliably can differentiate benign from malignant thyroid nodules.
Molecular profiles of benign (follicular adenomas, hyperplastic nodules) and malignant tumors (papillary thyroid carcinomas, follicular variants of papillary thyroid carcinomas) were analyzed using qRT-PCR from our 6-gene model (kit, Hs.296031, Hs.24183, LSM7, SYNGR2, C21orf4). The gold standard was standard pathologic criteria. A diagnosis-predictor model was built by using the training samples and was then used to predict the class of 10 additional samples analyzed as unknowns.
Our predictor model using 47 training samples correctly predicted 9/10 unknowns. One sample diagnosed as benign by standard histologic criteria was diagnosed as malignant by our model (sensitivity 75%; specificity, 100%; positive predictive value, 100%; negative predictive value, 85.7%).
Molecular diagnosis with our 6-gene model can differentiate between benign and malignant thyroid tumors with high sensitivity and specificity. In combination, these genetic markers may be a reliable test to preoperatively diagnose the malignant potential of thyroid nodules.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Management of a solitary thyroid nodule.N Engl J Med. 1993; 328: 553-559
- Usefulness of fine-needle aspiration in the diagnosis of thyroid carcinoma: A retrospective study in 37,895 patients.Cancer. 2000; 90: 357-363
- Gene expression profiling of lymphoid malignancies.Annu Rev Med. 2002; 53: 303-318
- Classification and diagnostic prediction of cancers using gene expression profiling and artificial neural networks.Nature Med. 2001; 7: 673-679
- Using gene expression ratios to predict outcome among patients with mesothelioma.J Natl Cancer Inst. 2003; 95: 598-605
- A gene-expression signature as a predictor of survival in breast cancer.N Engl J Med. 2002; 347: 1999-2009
- Classification of follicular thyroid tumors by molecular signature: Results of gene profiling.Clin Cancer Res. 2003; 9: 1792-1800
- A preoperative diagnostic test that distinguishes benign from malignant thyroid carcinoma based on gene expression.J Clin Inv. 2004; 113: 1234-1242
- Molecular profiling distinguishes papillary carcinoma from benign thyroid nodules.J Clin Endo Metab. 2004; 89: 3214-3223
- Discrimination of benign and malignant thyroid nodules by molecular profiling.Ann Surg. 2004; 240: 425-437
- Using gene expression profiling to differentiate benign versus malignant thyroid tumors.Cancer Res. 2004; 64: 2898-2903
- Expression profiles of 39 HOX genes in normal human adult organs and anaplastic thyroid cancer cell lines by quantitative real-time RT-PCR system.Exp Cell Res. 2004; 293: 144-153
Dziba JM, Ain KB. Imatinib mesylate (Gleevec;STI571) monotherapy is ineffective in suppressing human anaplastic thyroid carcinoma cell growth in vitro. J Clin Endo Met 89(5):2127-35.
- Transformation of thyroid epithelium is associated with loss of c-kit receptor.Cancer Res. 1995; 55: 1787-1791
- Characterization of the human synaptogyrin gene family.Hum Genet. 1998; 103: 131-141
- Yeast Sm-like proteins function in mRNA decapping and decay.Nature. 2000; 404: 515-518
- Carcinogenesis and translational controls: TACC is down-regulated in human cancers and associates with mRNA regulators.Oncogene. 2002; 21: 5619-5630
- Follicular thyroid lesions, elements that affect both diagnosis and prognosis.J Surg Onc. 2004; 89: 108-113
Bethesda and Baltimore, Md
Presented at the 26th Annual Meeting of the American Association of Endocrine Surgeons, a Cancun, Mexico, April 3-5, 2005.
© 2005 Mosby, Inc. Published by Elsevier Inc. All rights reserved.