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Updated: Apr 26, 2026
Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis
Published on: February 9, 2024
Proteomics for the diagnosis of thyroid lesions: preliminary report
F Pagni1, V Mainini2, M Garancini3
1Department of Pathology, San Gerardo Hospital, University Milan Bicocca, Monza, Italy.
Insights
Matrix-assisted laser desorption/ionization (MALDI) imaging mass spectrometry (IMS) shows promise for distinguishing thyroid lesions. This proteomic technology can identify new diagnostic markers in fine needle aspiration smears, aiding in preoperative diagnosis.
Area of Science:
- Proteomics
- Biomolecular analysis
- Medical diagnostics
Background:
- Matrix-assisted laser desorption/ionization (MALDI) imaging mass spectrometry (IMS) integrates molecular and morphological data for in situ biomolecule analysis.
- Previous studies demonstrated MALDI-IMS's utility in differentiating thyroid lesions, particularly papillary thyroid carcinoma (PTC).
- This study investigates MALDI-IMS for identifying proteomic targets in other thyroid lesions, including follicular lesions and medullary carcinoma.
Purpose of the Study:
- To assess the feasibility of MALDI-IMS on ex vivo fine needle aspiration (FNA) smears for thyroid lesion characterization.
- To explore the potential of MALDI-IMS in discovering novel proteomic biomarkers for thyroid cancer diagnosis.
- To evaluate the reproducibility and discriminatory power of MALDI-IMS for various thyroid pathologies.
Main Methods:
- MALDI-IMS was performed on ex vivo FNA samples from surgical specimens and corresponding in vivo samples.
- Proteomic profiles of different thyroid lesions were analyzed and compared.
- Reproducibility was assessed by comparing protein profiles within and between patient samples.
Main Results:
- High concordance in protein profiles of hyperplastic nodules indicated good reproducibility of MALDI-IMS on cytological samples.
- Significant differences in proteomic profiles were observed between hyperplastic nodules and Hürthle cell adenoma, demonstrating MALDI-IMS's capability to distinguish between lesion types.
- The proteomic profile of medullary thyroid carcinoma was successfully characterized.
Conclusions:
- MALDI-IMS shows potential for identifying diagnostic targets in papillary thyroid carcinoma and follicular lesions.
- These findings support the use of MALDI-IMS in larger trials for discovering proteins that can be translated into cost-effective diagnostic tools like immunohistochemistry.
- MALDI-IMS analysis of in vivo cytological smears could enhance the preoperative diagnosis of indeterminate thyroid nodules.
Objective:
Matrix-assisted laser desorption/ionization (MALDI) imaging mass spectrometry (IMS) is a unique proteomic technology that explores the spatial distribution of biomolecules directly in situ, thus integrating molecular and morphological information. The possibility of correlating distribution maps of multiple analyses with cytological features makes it an ideal research tool for discovering new diagnostic markers. A previous study showed that MALDI-IMS could help discrimination between different types of thyroid lesions, especially papillary thyroid carcinoma (PTC); the present feasibility study on ex vivo fine needle aspiration (FNA) smears describes its potential in detecting new proteomic targets of other thyroid lesions (follicular lesions, medullary carcinoma).
Methods:
MALDI-IMS was conducted on ex vivo FNAs obtained from surgical specimens and corresponding in vivo samples. Differences between proteomic profiles of different thyroid lesions were compared.
Results:
Comparing the protein profiles of hyperplastic nodules obtained from three different patients with each other, and with a new PTC, showed a high degree of concordance, indicating good reproducibility of the IMS technology on cytological samples, suggesting its potential as a tool for biomarker discovery. Furthermore, comparison of the average proteomic profiles of hyperplastic nodules with a Hürthle cell adenoma revealed significant differences, underlying the capability of MALDI-IMS to distinguish between different thyroid lesions. Finally, the proteomic profile of medullary thyroid carcinoma was also characterized.
Conclusions:
Our results confirmed the possible role of MALDI-IMS in the search for diagnostic targets of PTC and follicular lesions, which could be applied in larger trials aimed at the identification of proteins, convertible to cost-effective diagnostic tools such as immunohistochemistry. These tests could be used to analyse in vivo cytological smears, improving the preoperative diagnosis of indeterminate thyroid nodules.
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