Titov Sergei E, Kozorezova Evgeniya S, Lukyanov Sergei A, Sergiyko Sergei V, Demenkov Pavel S, Veryaskina Yulia A, Vorobyev Sergey L, Sleptsov Ilya V, Chernikov Roman A, Timofeeva Natalia I, Barashkova Svetlana V, Lushnikova Elena L, Uspenskaya Anna A, Zolotoukho Anna V, Romanova Olga V, Zhimulev Igor F
Department of the Structure and Function of Chromosomes, Institute of Molecular and Cellular Biology, Siberian Branch of the Russian Academy of Sciences, Novosibirsk 630090, Russia.
PCR Laboratory, AO Vector-Best, Novosibirsk 630117, Russia.
Diagnostics (Basel). 2024 Nov 25;14(23):2652. doi: 10.3390/diagnostics14232652.
BACKGROUND/OBJECTIVES: A modern classification distinguishes between two nosological entities posing an intermediate risk between differentiated and anaplastic carcinoma: poorly differentiated thyroid carcinoma and differentiated high-grade thyroid carcinoma. There are currently few studies searching for the preoperative molecular genetic markers of high-grade papillary thyroid carcinoma (PTC HG), primarily because of a recent WHO reclassification and singling out of a separate entity: high-grade follicular cell-derived nonanaplastic thyroid carcinoma. Therefore, this work was aimed at identifying PTC HG-specific microRNAs and mRNAs that reliably distinguish them from differentiated papillary thyroid carcinoma in preoperative cytology specimens (fine-needle aspiration biopsies).
A molecular genetic profile (expression levels of 14 genes and eight microRNAs) was studied in 110 cytology specimens from patients with PTC: 13 PTCs HG and 97 PTCs without features of HG.
Of the examined eight microRNAs and 14 genes, significant differences in the expression levels between the PTC and PTC HG groups were revealed for genes , , and . Only one gene () proved to be crucial for detecting PTC HG. It showed the largest area under the ROC curve (0.816) in differentiation between the PTC and PTC HG groups and was the key element of the decision tree by ensuring 54% sensitivity and 87.6% specificity.
Early preoperative diagnosis of PTC HG in patients with early stages of this cancer type will allow clinicians to modify a treatment strategy toward a larger surgery volume and lymph node dissection and may provide indications for subsequent radioactive iodine therapy.
背景/目的：现代分类法区分出两种介于分化型癌和间变性癌之间具有中等风险的疾病实体：低分化甲状腺癌和高分化甲状腺癌。目前，很少有研究寻找高分化乳头状甲状腺癌（PTC HG）的术前分子遗传标志物，主要原因是世界卫生组织最近进行了重新分类，并单独划分出一个独立的实体：高分化滤泡细胞源性非间变性甲状腺癌。因此，本研究旨在鉴定PTC HG特异性的微小RNA和信使核糖核酸，以便在术前细胞学标本（细针穿刺活检）中可靠地将它们与分化型乳头状甲状腺癌区分开来。
对110例PTC患者的细胞学标本（13例PTC HG和97例无HG特征的PTC）进行分子遗传学分析（14个基因和8个微小RNA的表达水平）。
在所检测的8个微小RNA和14个基因中，发现基因 、 和 在PTC组和PTC HG组之间的表达水平存在显著差异。只有一个基因（ ）被证明对检测PTC HG至关重要。它在区分PTC组和PTC HG组时显示出最大的ROC曲线下面积（0.816），并且通过确保54%的敏感性和87.6%的特异性，成为决策树的关键要素。
对该癌症早期患者进行PTC HG的早期术前诊断将使临床医生能够调整治疗策略，采用更大范围的手术和淋巴结清扫，并可能为后续的放射性碘治疗提供依据。
