J Korean Soc Endocrinol.  2002 Aug;17(4):501-513.

Molecular Diagnosis of Recurrent Thyroid Cancer by Reverse Transcription-Polymerase Chain Reaction of Thyroglobulin Messenger Ribonucleic Acid in Peripheral Blood

Affiliations
  • 1Department of Internal Medicine, Kosin University College of Medicine, Pusan, Korea.
  • 2Department of Otolaryngology, Kosin University College of Medicine, Pusan, Korea.
  • 3Department of Nuclear Medicine, Kosin University College of Medicine, Pusan, Korea.
  • 4Department of Internal Medicine, Pusan Adventist Hospital, Pusan, Korea.

Abstract

BACKGROUND: Differentiated thyroid cancer is the most common endocrine malignancy. Despite advances in the treatment of thyroid cancer, disease recurrence and metastasis may occur in as many as 20% of patients, and so continues to pose major problems in its clinical management. Serum thyroglobulin (Tg) measurements, by immunoassay, are used to detect residual or recurrent thyroid cancer following thyroid ablation. However, the usefulness of immunoassay is limited by both the requirement for thyroid hormone withdrawal, to attain optimal test sensitivity, and interference by the antithyroglobulin antibody (Anti-Tg Ab). Recent studies have reported the clinical usefulness of reverse transcription-polymerase chain reaction (RT-PCR) detection of Tg mRNA in the peripheral blood of patients with differentiated thyroid carcinomas. We performed this study to evaluate the usefulness RT-PCR of Tg mRNA in peripheral blood of patients with thyroid carcinoma following a total thyroidectomy and radioiodine ablation therapy.
METHODS
Forty cases that underwent a total thyroidectomy and radioiodine ablation therapy were included in this study. Of the 40 patients, 35 were papillary carcinomas and 5 were follicular carcinomas. Ten normal control subjects were also studied. Tg mRNA was extracted. Then RT-PCR, and nested RT-PCR, were run with specific Tg primers. Concurrently, DNA sequencing of the isolates was carried out to prove the isolates were identical to the nucleotide sequence of the Tg.
RESULTS
The Tg was detected in 4 of 19 patients, with either a residual thyroid bed, or metastasis, on a 131I whole body scan and in 1 of 21 patients with a negative radioiodine scan. Surprisingly, the Tg mRNA was detected in all the patients and normal controls.
CONCLUSION
From our results we can not recommend Tg mRNA, detected by RT-PCR in peripheral blood, as a tumor marker superior to that of the Tg serum level. We consider an intensive re-evaluation of the method is required before considering its clinical applications.


MeSH Terms

Base Sequence
Carcinoma, Papillary
Diagnosis*
Humans
Immunoassay
Neoplasm Metastasis
Recurrence
RNA*
RNA, Messenger
Sequence Analysis, DNA
Thyroglobulin*
Thyroid Gland*
Thyroid Neoplasms*
Thyroidectomy
Whole Body Imaging
RNA
RNA, Messenger
Thyroglobulin
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