Personalized Follow Up in Thyroid Cancer Using Molecular Markers

Kim, Tae Yong

Abstract

Clinical guidelines for initial management and long-term follow-up of thyroid cancer have been published from many societies world-widely, but there are still many unanswered clinical situation by conventional approach. The prognostic role of BRAF V600E mutation status in patients with papillary thyroid microcarcinoma has been reported and surgical extent could be guided by preoperative assessment of BRAF V600E status from fine needle aspirates. The most important prognostic parameters thyroid cancer after total thyroidectomy and radioactive iodine treatment is measurement of serum thyroglobulin (Tg). Thyrolgobulin autoantiboies (TgAb) is detected up to 25 percent of thyroid cancer patients and may be potential cause of false negative Tg. To overcome this caveat, measurement of transcript of thyroid tissue specific gene could be a substitute for Tg. Serum Tg measurement is also not helpful for thyroid cancer patients who received partial thyroidectomy. Because Tg is tissue specific marker, not cancer specific marker, i.e. normal remnant thyroid tissue could be potential source of Tg. Recent approach to measure BRAF V600E mutation from peripheral blood could be a good candidate tumor marker in patients with normal remnant thyroid tissue. Recent introduction of novel molecular markers for thyroid cancer could be a promising answer to previous guideline for individualize follow-up of thyroid cancer patients.