Publication:


abstract

PURPOSE:

indeterminate thyroid lesions on fine needle aspiration (FNA) harbor malignancy in about 25% of cases. Hemi- or total thyroidectomy has, therefore, been routinely advocated for definitive diagnosis. In this study, we analyzed miRNA expression in indeterminate FNA samples and determined its prognostic effects on final pathologic diagnosis.

EXPERIMENTAL DESIGN:

A predictive model was derived using 29 ex vivo indeterminate thyroid lesions on FNA to differentiate malignant from benign tumors at a tertiary referral center and validated on an independent set of 72 prospectively collected in vivo FNA samples. Expression levels of miR-222, miR-328, miR-197, miR-21, miR-181a, and miR-146b were determined using reverse transcriptase PCR. A statistical model was developed using the support vector machine (SVM) approach.

RESULTS:

A SVM model with four miRNAs (miR-222, miR-328, miR-197, and miR-21) was initially estimated to have 86% predictive accuracy using cross-validation. When applied to the 72 independent in vivo validation samples, performance was actually better than predicted with a sensitivity of 100% and specificity of 86%, for a predictive accuracy of 90% in differentiating malignant from benign indeterminate lesions. When Hurthle cell lesions were excluded, overall accuracy improved to 97% with 100% sensitivity and 95% specificity.

CONCLUSIONS:

This study shows that that the expression of miR-222, miR-328, miR-197, and miR-21 combined in a predictive model is accurate at differentiating malignant from benign indeterminate thyroid lesions on FNA. These findings suggest that FNA miRNA analysis could be a useful adjunct in the management algorithm of patients with thyroid nodules.

©2012 AACR.

Related Articles
MicroRNA expression profiling is a potential diagnostic tool for thyroid cancer.
Cancer. 2011
MicroRNA expression profiling is a potential diagnostic tool for thyroid cancer.
Vriens MR, Weng J, Suh I, Huynh N, Guerrero MA, Shen WT, Duh QY, Clark OH, Kebebew E. Cancer. 2011 Oct 17; . Epub 2011 Oct 17.
MicroRNA signature in thyroid fine needle aspiration cytology applied to "atypia of undetermined significance" cases.
Thyroid. 2012
MicroRNA signature in thyroid fine needle aspiration cytology applied to "atypia of undetermined significance" cases.
Shen R, Liyanarachchi S, Li W, Wakely PE Jr, Saji M, Huang J, Nagy R, Farrell T, Ringel MD, de la Chapelle A, et al. Thyroid. 2012 Jan; 22(1):9-16. Epub 2011 Dec 2.
Galectin-3-expression analysis in the surgical selection of follicular thyroid nodules with indeterminate fine-needle aspiration cytology: a prospective multicentre study.
Lancet Oncol. 2008
Galectin-3-expression analysis in the surgical selection of follicular thyroid nodules with indeterminate fine-needle aspiration cytology: a prospective multicentre study.
Bartolazzi A, Orlandi F, Saggiorato E, Volante M, Arecco F, Rossetto R, Palestini N, Ghigo E, Papotti M, Bussolati G, et al. Lancet Oncol. 2008 Jun; 9(6):543-9. Epub 2008 May 19.
Review Beyond the suspicious thyroid fine needle aspirate. A review.
Acta Cytol. 2003
Review Beyond the suspicious thyroid fine needle aspirate. A review.
Segev DL, Clark DP, Zeiger MA, Umbricht C. Acta Cytol. 2003 Sep-Oct; 47(5):709-22.
Review Thyroid nodules; interpretation and importance of fine-needle aspiration (FNA) for the clinician - practical considerations.
Surg Oncol. 2010
Review Thyroid nodules; interpretation and importance of fine-needle aspiration (FNA) for the clinician - practical considerations.
Sakorafas GH. Surg Oncol. 2010 Dec; 19(4):e130-9.