Lee Yeongun, Park Hyo Jin, Lee Jin Seok, Jeong Ho Jung, Kim Su Min, Cho Minjeong, Woo Wonjin, Dho So Hee, Kim Seok-Mo, Kim Lark Kyun
Department of Biomedical Sciences, Graduate School of Medical Science, Brain Korea 21 Project, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Institute of Refractory Thyroid Cancer, Yonsei University College of Medicine, Seoul, Republic of Korea.
NPJ Precis Oncol. 2025 May 10;9(1):136. doi: 10.1038/s41698-025-00932-7.
Papillary thyroid carcinoma (PTC) is the most prevalent form of thyroid cancer with generally favorable outcomes. However, surgeons often face challenges regarding optimal surgical timing, extent of surgery, and identifying patients at risk for metastasis or progression to more aggressive subtypes. The ongoing debate over immediate surgery versus active surveillance emphasizes the need for reliable, minimally invasive diagnostic tools to inform surgical decision-making. This study aims to develop an epigenetic biomarker-based prediction system using fine-needle aspiration biopsy (FNAB) samples to assess PTC aggressiveness preoperatively. We conducted a comprehensive analysis of methylome data to identify approximately 7200 CpG islands with altered methylation levels in thyroid cancer tissues. These candidate regions were further examined in our cohort of 55 PTC patients to develop methylation-specific primers suitable for FNAB samples. Methylation patterns allowed us to stratify patients into two distinct prognostic groups, one of which exhibited a poorer survival rate. Our methylation-specific primers effectively classified FNAB samples into these groups, demonstrating their potential as a preoperative tool for assessing tumor aggressiveness. This stratification aids in informing surgical planning and personalizing treatment strategies. DNA methylation profiling of PTC identifies key epigenetic biomarkers associated with tumor aggressiveness. Utilizing these biomarkers in FNAB samples provides a minimally invasive method for preoperative risk assessment, assisting surgeons in tailoring surgical interventions and potentially improving patient outcomes.
甲状腺乳头状癌（PTC）是最常见的甲状腺癌形式，总体预后良好。然而，外科医生在确定最佳手术时机、手术范围以及识别有转移风险或进展为更具侵袭性亚型的患者方面常常面临挑战。关于立即手术与积极监测的持续争论凸显了对可靠的、微创诊断工具的需求，以指导手术决策。本研究旨在开发一种基于表观遗传生物标志物的预测系统，使用细针穿刺活检（FNAB）样本术前评估PTC的侵袭性。我们对甲基化组数据进行了全面分析，以识别甲状腺癌组织中甲基化水平改变的约7200个CpG岛。在我们的55例PTC患者队列中进一步检查这些候选区域，以开发适用于FNAB样本的甲基化特异性引物。甲基化模式使我们能够将患者分为两个不同的预后组，其中一组生存率较差。我们的甲基化特异性引物有效地将FNAB样本分为这些组，证明了它们作为术前评估肿瘤侵袭性工具的潜力。这种分层有助于指导手术规划和个性化治疗策略。PTC的DNA甲基化谱分析确定了与肿瘤侵袭性相关的关键表观遗传生物标志物。在FNAB样本中利用这些生物标志物提供了一种微创的术前风险评估方法，帮助外科医生调整手术干预措施，并可能改善患者预后。
