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Title: Circulating thyrotropin receptor messenger ribonucleic acid is not an effective marker in the follow-up of differentiated thyroid carcinoma
Authors: Surasawadee Ausavarat
Jiraporn Sriprapaporn
Busara Satayaban
Wanna Thongnoppakhun
Aunchalee Laipiriyakun
Boontham Amornkitticharoen
Rujaporn Chanachai
Chaveevan Pattanachak
Mahidol University. Faculty of Medicine Siriraj Hospital. Nuclear Chemistry Laboratory
Keywords: Open Access article;TSHR mRNA;Thyroid mRNA;qPCR;DTC
Issue Date: 2015
Citation: Thyroid Research. Vol. 8, (2015), 11
Abstract: Background: Circulating thyrotropin receptor messenger ribonucleic acid (TSHR mRNA) assay has been validated in the follow-up of differentiated thyroid carcinoma (DTC) because of its high sensitivity during thyroid hormone therapy and no interference with endogenous anti-thyroglobulin antibodies (TgAb) compared to serum thyroglobulin (Tg). We investigated the efficacy of TSHR mRNA assay in 160 DTC patients using quantitative PCR (qPCR). Findings: Only TSHR mRNA level of structural persistent disease with TgAb-positive (3.47 (2.97–9.53) pg equivalents/μg total RNA; p = 0.013) and its subgroup of distant metastasis patients with TgAb-positive (5.55 (3.28–12.52) pg equivalents/ μg total RNA; p = 0.009) were significantly different from patients with no evidence of disease (2.32 (1.44–3.94) pg equivalents/μg total RNA). Applying cutoff at 2.00 pg equivalents/μg total RNA enabled us to predict structural persistent disease patients with a sensitivity of 62.3 % and a specificity of 42.9 %. Although, the sensitivity of TSHR mRNA assay in TgAb-postive patients (88.2 %) was superior than serum Tg (47.1 %) (p = 0.00002), the accuracy of the test is only 54.5 %. Conclusions: This study demonstrated that TSHR mRNA assay has good sensitivity in TgAb-positive patients but it is neither specific enough as a first-line of testing nor a surrogate marker in the follow-up of our DTC patients.
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