Improving diagnosis of thyroid nodules

September 6, 2012
Thyroid nodules are thought to be present in about half of all people, but very few of these are cancerous. Credit: Dr. Sara Tomei

Thyroid nodules are thought to be present in about half of all people, but very few of these are cancerous. New research published in BioMed Central's open access journal BMC Cancer presents a set of diagnostic biomarkers which are able to distinguish between malignant and benign thyroid nodules.

Thyroid nodules are first assessed using (FNA) cytology. But about a third of results come back as indeterminate and require a diagnostic thyroidectomy. Of these, only about 20% turn out to be malignant. Obviously that 20% require further treatment (usually a full thyroidectomy) but the other 80% have had unnecessary, but currently unavoidable, surgery. If only there was a better way.

Researchers from University of Pisa and Pisa University Hospital, Italy led by Dr. Chiara Mazzanti, have addressed this problem using a Bayesian model to examine from over 90 different FNA. They found eight biomarkers each capable alone, or in combination, to distinguish between malignant and benign samples. In a test group the gene activity set (KIT, CDH1, LSM7, C21orf4, DDI2, TC1, Hs.296031 and BRAF) was able to correctly identify malignant and benign tumours 89% of the time.

Dr Sara Tomei, explained, "Almost half of all the malignant samples (but none of the benign samples) carried the V600E mutation in the gene BRAF. We would recommend that a sample with unclear cytology which contains this mutation be treated as malignant. The gene with the highest predictive power was KIT. KIT activity is turned down in , so BRAF-normal samples, with low levels of KIT, should also be treated as suspected cancer."

Following on from this, the team suggests that patients' samples with BRAF-normal, but indeterminate KIT activity, be tested against the entire test. Any remaining ambiguous results can then be tested with the current diagnostic . Following this stepwise approach, they suggest, could potentially reduce the numbers of people with benign nodules being treated with radical surgery by almost 50%, yet still identify the people who require thyroidectomies to treat their cancer.

Explore further: Gene expression test identifies low-risk thyroid nodules

More information: A molecular computational model improves the preoperative diagnosis of thyroid nodules, Sara Tomei, Ivo Marchetti, Katia Zavaglia, Francesca Lessi, Alessandro Apollo, Paolo Aretini, Giancarlo Di Coscio, Generoso Bevilacqua and Chiara Mazzanti, BMC Cancer (in press)

Related Stories

Gene expression test identifies low-risk thyroid nodules

June 25, 2012
A new test can be used to identify low-risk thyroid nodules, reducing unnecessary surgeries for people with thyroid nodules that have indeterminate results after biopsy. The results of the multi-center trial, which includes ...

Despite obstacles, fine needle aspiration might be best diagnostic tool

April 15, 2012
Screening for lung cancer with low dose CT scans has been shown to save lives. However, research shows that when CT scans reveal nodules in the lungs, it is not cancerous 96 percent of the time. As a result, scientists are ...

BRAF addiction of thyroid cancers makes them therapeutically vulnerable

November 21, 2011
Papillary carcinoma is the most common form of thyroid cancer. Approximately one quarter of these carcinomas have mutations in the BRAF gene. The prevalence of such mutations is even greater in high-grade carcinomas, particularly ...

Recommended for you

Shooting the achilles heel of nervous system cancers

July 20, 2017
Virtually all cancer treatments used today also damage normal cells, causing the toxic side effects associated with cancer treatment. A cooperative research team led by researchers at Dartmouth's Norris Cotton Cancer Center ...

Molecular changes with age in normal breast tissue are linked to cancer-related changes

July 20, 2017
Several known factors are associated with a higher risk of breast cancer including increasing age, being overweight after menopause, alcohol intake, and family history. However, the underlying biologic mechanisms through ...

Immune-cell numbers predict response to combination immunotherapy in melanoma

July 20, 2017
Whether a melanoma patient will better respond to a single immunotherapy drug or two in combination depends on the abundance of certain white blood cells within their tumors, according to a new study conducted by UC San Francisco ...

Discovery could lead to better results for patients undergoing radiation

July 19, 2017
More than half of cancer patients undergo radiotherapy, in which high doses of radiation are aimed at diseased tissue to kill cancer cells. But due to a phenomenon known as radiation-induced bystander effect (RIBE), in which ...

Definitive genomic study reveals alterations driving most medulloblastoma brain tumors

July 19, 2017
The most comprehensive analysis yet of medulloblastoma has identified genomic changes responsible for more than 75 percent of the brain tumors, including two new suspected cancer genes that were found exclusively in the least ...

Novel CRISPR-Cas9 screening enables discovery of new targets to aid cancer immunotherapy

July 19, 2017
A novel screening method developed by a team at Dana-Farber/Boston Children's Cancer and Blood Disorders Center—using CRISPR-Cas9 genome editing technology to test the function of thousands of tumor genes in mice—has ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.