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. 2023 May 18;11(5):1473.
doi: 10.3390/biomedicines11051473.

New Opportunities for Preoperative Diagnosis of Medullary Thyroid Carcinoma

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New Opportunities for Preoperative Diagnosis of Medullary Thyroid Carcinoma

Sergei A Lukyanov et al. Biomedicines. .

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.

Keywords: calcitonin; fine-needle aspiration samples; medullary thyroid carcinoma; miRNA-375; molecular testing.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Scheme for analyzing miRNA-375 and preoperative basal calcitonin in group 1 and 2 patients.
Figure 2
Figure 2
The relative expression level of miRNA-375 in goiters and thyroid/parathyroid tumors. The figure presents the median value, upper and lower quartiles, and non-outlier range, and outliers (circles). MTC, medullary thyroid carcinoma; PTC, papillary thyroid carcinoma; FTC, follicular thyroid carcinoma; OTC, oncocytic thyroid carcinoma; PTA, parathyroid adenoma; OA, oncocytic adenoma; and FA, follicular adenoma.

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