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

Department of General Surgery, Cleveland Clinic, OH 44195, USA.
Annals of Surgical Oncology (Impact Factor: 3.93). 11/2008; 16(2):473-80. DOI: 10.1245/s10434-008-0211-9
Source: PubMed


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.

4 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Geo-spatial Information Engineering (GSIE) that is also called Digital Engineering is the information engineering on the basis of the integration of Remote Sensing, Geographic Information System and other information technologies. The information standard that includes standard architecture, rules, criterion and policy is an important component of GSIE. The author studies the concept, object and aim of Standard of GSIE, discusses the planning, architecture and reference model and how to develop the system of Specialized Standard of GSIE. The Standard of GSIE is the uniform regulation of the data resources, information flow, information construction and management of GSIE. The object of Standardization of GSIE is a mass of repeat data resources and disposal businesses. The aim of Standard of GSIE includes: building a set of application-oriented standard framework, depicting the Geo-spatial information basic semantic and structure; building the related models; regulating the geo-spatial service contents and geo-spatial processing service to realize the inter-operation. The technology approach of Standard of GSIE is: ascertaining the discussion domain-building the concept schema-realizing the operation. The architecture of Standard of GSIE makes up of three parts: Direction Standard, Basic Standard and Specialized Standard. The reference model of Standard of GSIE describes the overall aim, basic concept, architecture, framework, relations among all kinds of standards. The architecture is the wholeness that is arranged according the inter-relation. The representation is the s diagrams of standard system. The author expands the Basic Standard to fulfill the practice requirement by means of profile method, builds the geo-spatial information domain and reference structure, develops the information standard system of the level of geo-spatial dataset and information service
    Geoscience and Remote Sensing Symposium, 2004. IGARSS '04. Proceedings. 2004 IEEE International; 10/2004
  • [Show abstract] [Hide abstract]
    ABSTRACT: Physical and chemical parameters of medlar fruit are necessary for the design of equipment to handle, harvest, process, store the product and nutrition values. In this study, the medlar (Mespilus germanica L.) fruit was studied to determine for some physical (dimension, geometric mean diameter, sphericity, bulk density, fruit density, volume, hardness and porosity) and chemical (moisture, crude protein, oil, energy, fibre and ash, pH, acidity, water-soluble extract, alcohol-soluble extract and ether-soluble extracts) properties. Moisture, crude oil, protein, fibre, energy, and ash, acidity, pH, water-soluble extract, alcohol-soluble and ether-soluble were found to be 72.15%, 4.09%, 3.71%, 11.4%, 16.5 kcal/g, 1.96%, 0.28%, 4.26, 68.89%, 53.35% and 2.41% (dry basis (except for pH)), respectively. Inductively coupled plasma atomic emission spectrometer (ICP-AES) determined the mineral content of medlar fruit. Potassium (8052.91 mg/kg) was present in the highest concentration, following S, Ca, B and P. Also, K, S, Ca, B and S were present in higher concentrations, and traces of Cr, Ti and V were also determined. The fruit mass, diameter, volume, geometric mean diameter, sphericity and projected area were measured as 11.98 g, 27.68 mm, 13.68 cm3, 28.86 mm, 0.92, and 9.25 cm2, respectively. The changes in physical and chemical properties of fruits having about the same size were probably due to environmental conditions in conjunction with the analytical methods used. Consequently, the analytical values showed rich nutritional properties and mineral contents of medlar fruits. Also, the mineral content of medlar fruit is of great interest. In addition, knowledge of the physical properties of equipment used in planting, harvesting, transportation, storage and processing of matured medlar fruits is very important.
    Journal of Food Engineering 07/2005; 69(1):1-7. DOI:10.1016/j.jfoodeng.2004.07.004 · 2.77 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: 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. We compared clinical characteristics of 37 patients with papillary thyroid microcarcinomas (PTMC; tumor size </=1 cm) having undetectable (-) versus detectable (+)TSHR mRNA. 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. 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.
    Surgery 12/2009; 146(6):1081-9. DOI:10.1016/j.surg.2009.09.008 · 3.38 Impact Factor
Show more