Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Jun;98(6):753-762.
doi: 10.1111/cen.14882. Epub 2023 Feb 8.

Clinical value of molecular markers as diagnostic and prognostic tools to guide treatment of thyroid cancer

Pablo Valderrabano  1 , Markus Eszlinger  2   3 , Paul Stewardson  4 , Ralf Paschke  5
Affiliations
Review

Clinical value of molecular markers as diagnostic and prognostic tools to guide treatment of thyroid cancer

Pablo Valderrabano et al. Clin Endocrinol (Oxf). 2023 Jun.

Abstract

Objective: Advances in our understanding of the molecular biology of thyroid tumours is being rapidly translated into their clinical management. This review summarizes the current use of molecular testing in thyroid tumours, focusing on their usefulness as diagnostic and prognostic tools to guide treatment with consideration of present limitations.

Design: Considerations about molecular testing applications for the diagnosis and treatment of thyroid tumours are divided into four sections/roles: (1) evaluating cytologically indeterminate thyroid nodules; (2) guiding extent of surgery in indeterminate thyroid nodules; (3) completing histological characterization of thyroid tumours and (4) identifying actionable mutations in advanced progressive thyroid cancers.

Results: Genomic testing can improve the presurgical malignancy risk assessment in indeterminate thyroid nodules. However, a prior in-depth analysis of institutional quality and outcomes of sonographical, cytological and histological characterization of thyroid tumours is necessary. Presently, it remains uncertain whether knowing the molecular profile of a cytologically indeterminate thyroid nodule might be advantageous to modify the extent of initial surgery. Molecular characterization of thyroid tumours can be a valuable adjunct to morphological diagnosis in some challenging cases, such as in low-risk follicular cell-derived neoplasms, or rare tumours. Finally, as selective kinase inhibitors are available, molecular testing in locally advanced/metastatic progressive thyroid cancers should also be integrated into the institutional clinical management pathway to improve outcomes and limit toxicity.

Conclusions: Molecular testing needs to be implemented into the local evidence-based clinical management thyroid nodule/cancer pathways to improve its diagnostic and prognostic value and to optimize cost-effectiveness.

Keywords: diagnosis; gene expression; oncology; testing; thyroid cancer; thyroid nodule; thyroid pathology.

PubMed Disclaimer

References

REFERENCES

    1. Guth S, Theune U, Aberle J, Galach A, Bamberger CM. Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination. Eur J Clin Invest. 2009;39(8):699-706.
    1. Völzke H, Ittermann T, Albers M, et al. Five-year change in morphological and functional alterations of the thyroid gland: the Study of Health in Pomerania. Thyroid. 2012;22(7):737-746.
    1. Völzke H, Craesmeyer C, Nauck M, et al. Association of socioeconomic status with iodine supply and thyroid disorders in northeast Germany. Thyroid. 2013;23(3):346-353.
    1. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1-133.
    1. Gharib H, Papini E, Garber JR, et al. American Association of Clinical Endocrinologists, American College of Endocrinology, and Associazione Medici Endocrinologi Medical Guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract. 2016;22(5):622-639.

LinkOut - more resources