Quantitation of thyroid-stimulating hormone receptor mRNA with real-time PCR for early diagnosis of papillary thyroid...

Recently, the value of thyroid-stimulating hormone receptor(TSHR) mRNA as a molecular marker in diagnosis of thyroid cancer has been greatly explored. However, its role in detecting thyroid microcarcinoma has never been reported. In this study, we aim to investigate the value of TSHR mRNA in diagnosis of papillary thyroid microcarcinoma(PTMC). To do that, TSHR mRNA levels were measured by real time PCR in 30 healthy subjects and 72 patients (benign thyroid nodules, n=38; PTMC, n=34). TSHR mRNA levels were then compared with cancer volume in surgical specimen. We found that TSHR mRNA levels in PTMC were significantly higher than benign thyroid nodules(P<0.01). At a cutoff value of 0.71 ng/microg total RNA, the TSHR mRNA correctly classified 77.8% of patients preoperatively (sensitivity= 76.5%; specificity= 79.4%). Comparatively, it performed better in larger PTMC of 0.5-1.0 cm than <0.5 cm(sensitivity, 83.4% vs 72.4%; specificity, 88.5% vs 74.1%). Combining TSHR mRNA and ultra sound examination correctly detect 97.1% of PTMC and could spared surgery in 86.8% of patients with benign thyroid nodules. Thus, TSHR mRNA measured with real time PCR enhances the preoperative detection of PTMC in patients with thyroid nodules, which dramatically reduces unnecessary surgeries.

thyroid-stimulating hormone receptor, papillary thyroid microcarcinoma, diagnosis.