New Opportunities for Preoperative Diagnosis of Medullary Thyroid Carcinoma

Abstract

The preoperative diagnostics of medullary thyroid carcinoma (MTC), including the measuring of the blood calcitonin level, has a number of limitations. Particular focus has recently been placed on the role of miRNAs in the development of various malignant tumors; a comparative analysis of accuracy of the existing methods for MTC diagnosis with a novel diagnosis method, evaluation of the miRNA-375 expression level, was performed in this study. The expression level of miRNA-375 in cytology samples from 555 patients with the known histological diagnosis, including 41 patients with confirmed postoperative diagnosis of MTC, was assessed. The diagnostic parameters of the basal calcitonin level, calcitonin in wash-out fluid from the FNAB needle, and miRNA-375 were compared. An assessment of the miRNA-375 expression level made it possible to detect all the MTC samples with a 100% accuracy among all the 555 cytology specimens, as well as in non-informative FNAB specimens, and specimens from the ipsilateral thyroid lobe. Parameters such as sensitivity, specificity, PPV, and NPV were 100%. The miRNA-375 level, unlike calcitonin, does not correlate with tumor volume, so it does not have the so-called “gray zone”. An assessment of the miRNA-375 expression allows one to accurately distinguish MTC from other malignant and benign thyroid tumors.

An old friend, a new insight: Calcitonin measurement in serum and aspiration needle washout fluids significantly increases the early and accurate detection of medullary thyroid cancer

“…Recently, the introduction of molecular testing kits to confirm MTC diagnoses using inconclusive FNA samples has marked a substantial advancement. [46][47][48][49] Nevertheless, it is essential to highlight the lack of comprehensive prospective studies that specifically investigate the assessment and screening of MTC through these molecular testing kits. The persistent challenges related to accessibility and cost are worth noting, particularly for countries outside the United States.…”

“…In cases of inadequate or suboptimal cytologic specimens, identifying MTC may not be possible using this method. Recently, the introduction of molecular testing kits to confirm MTC diagnoses using inconclusive FNA samples has marked a substantial advancement 46–49 . Nevertheless, it is essential to highlight the lack of comprehensive prospective studies that specifically investigate the assessment and screening of MTC through these molecular testing kits.…”

MicroRNAs in thyroid cancer with focus on medullary thyroid carcinoma: potential therapeutic targets and diagnostic/prognostic markers and web based tools

“…Comparing different methods for MTC diagnosis showed that evaluating the miRNA-375 transcription level precisely distinguishes MTC vs . remaining thyroid tumors moreover unlike calcitonin, the miRNA-375 level is not related to tumor volume [ 39 ]. Additionally, miR-375 transcription serves as an MTC negative marker.…”