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Gene expression profiling of thyroid tumors—clinical applicability

Nature Clinical Practice Endocrinology & Metabolism volume 2, pages 472–473 (2006)Cite this article

Over the past decade, studies of gene expression profiling have inundated the scientific literature. The potential contribution of this novel, high-throughput method for genomic investigation and clinical diagnostics is immense. We can now assess the expression of tens of thousands of genes in a single assay. Despite these advances, however, important questions remain unanswered. For example, how do we filter this information to determine the relevant diagnostic or prognostic markers, and is expression profiling reliable, accurate, and practical enough to become clinically applicable?

Thyroid nodules provide an excellent model to illustrate the potential of gene profiling. These lesions—already common in the population—are now being found incidentally with increasing frequency, secondary to the increased use and sensitivity of ultrasound screening for diseases of the carotid, parathyroid, and thyroid. As a result, more fine-needle aspiration (FNA) biopsies are being performed. Although FNA has greatly improved preoperative diagnostic accuracy, halving the number of patients who require surgery, this technique fails to distinguish benign follicular lesions from malignant tumors, and is subject to the interobserver variability common to qualitative classification schemes. Additionally, 'nondiagnostic' and 'indeterminate' or 'suspicious' aspirates—a diagnosis cited in over 25% of FNA samples—maintain a considerable risk of cancer. The advent of microarray technology promises robust and quantitative interrogation at the molecular level, thereby circumventing the current limitations of FNA.

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References

  1. Mazzanti C et al. (2004) Using gene expression profiling to differentiate benign versus malignant thyroid tumors. Cancer Res 64: 2898–2903

    Article  CAS  Google Scholar 

  2. Finley D et al. (2004) Discrimination of benign and malignant thyroid nodules by molecular profiling. Ann Surg 240: 425–436

    Article  Google Scholar 

  3. Giordano TJ et al. (2005) Molecular classification of papillary thyroid carcinoma: distinct BRAF, RAS, and RET/PTC mutation-specific gene expression profiles discovered by DNA microarray analysis. Oncogene 24: 6646–6656

    Article  CAS  Google Scholar 

  4. Xing M et al. (2005) BRAF mutation predicts a poorer clinical prognosis for papillary thyroid cancer. J Clin Endocrinol Metab 90: 6373–6379

    Article  CAS  Google Scholar 

  5. Wreesmann VB et al. (2004) Genome-wide profiling of papillary thyroid cancer identifies MUC1 as an independent prognostic marker. Cancer Res 64: 3780–3789

    Article  CAS  Google Scholar 

  6. Draghici S et al. (2006) Reliability and reproducibility issues in DNA microarray measurements. Trends Genet 22: 101–109

    Article  CAS  Google Scholar 

  7. Cerutti J et al. (2004) A preoperative diagnostic test that distinguishes benign from malignant thyroid carcinoma based on gene expression. J Clin Invest 113: 1234–1242

    Article  CAS  Google Scholar 

  8. Kebebew E et al. (2005) ECM1 and TMPRSS4 are diagnostic markers of malignant thyroid neoplasms and improve accuracy of fine needle aspiration biopsy. Ann Surg 242: 353–361

    PubMed  PubMed Central  Google Scholar 

  9. Hamada A et al. (2005) Diagnostic usefulness of PCR profiling of the differentially expressed marker genes in thyroid papillary carcinomas. Cancer Lett 224: 289–301

    Article  CAS  Google Scholar 

  10. Weber F et al. (2005) Genetic classification of benign and malignant thyroid follicular neoplasia based on a three-gene combination. J Clin Endocrinol Metab 90: 2512–2521

    Article  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Surgery,

    Carrie C Lubitz & Thomas J Fahey III

  2. Department of Surgery, Weill Medical College of Cornell University, New York, NY, USA

    Carrie C Lubitz & Thomas J Fahey III

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  1. Carrie C Lubitz
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  2. Thomas J Fahey III
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Correspondence to Carrie C Lubitz.

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The authors declare no competing financial interests.

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Lubitz, C., Fahey, T. Gene expression profiling of thyroid tumors—clinical applicability. Nat Rev Endocrinol 2, 472–473 (2006). https://doi.org/10.1038/ncpendmet0271

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