Background
Circulating thyroid cancer cells detected by peripheral blood thyroid-stimulating
hormone receptor (TSHR) mRNA have demonstrated usefulness for thyroid cancer diagnosis
and long-term surveillance. The aim of this study was to determine detectability and
clinical importance of TSHR mRNA in patients with microcarcinomas.
Methods
We compared clinical characteristics of 37 patients with papillary thyroid microcarcinomas
(PTMC; tumor size ≤1 cm) having undetectable (–) versus detectable (+)TSHR mRNA.
Results
59 Of the PTMC patients, 59% had (+)TSHR mRNA levels, similar to those with tumors
>1 cm (72%; P = NS) and distinctly higher than false (+) rates in benign goiters (15%; P < .001). All patients with (–)TSHR mRNA had classical PTMC, whereas variants (32%)
occurred with (+)mRNA (P = .001). Mean tumor size (5 mm) and multifocality rates (45%) were similar in both
mRNA groups. Of the PTMC patients, 35% had concurrent cervical nodal metastases, which
occurred more frequently with tumors ≥5 mm (P = .04) and with (+)TSHR mRNA in pre-operatively known PTMC (P < .05). No patients with incidentally detected PTMC and (–)TSHR mRNA had metastases.
Conclusion
This study is the first to demonstrate that TSHR mRNA, reflecting circulating thyroid
cancer cells, is detectable even with thyroid microcarcinomas. PTMC with (+)TSHR mRNA
may characterize patients with potentially more aggressive histology at initial operation.
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Article info
Publication history
Accepted:
September 17,
2009
Identification
Copyright
© 2009 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
