Background: Follicular thyroid carcinoma (FC) accounts for 10–15% of all thyroid cancers. FC is challenging to diagnose using fine-needle aspiration (FNA), making diagnostic thyroidectomy the standard approach. Recent studies have explored the use of circulating microRNAs for thyroid cancer diagnosis. This study evaluated the diagnostic value of circulating miRNAs in plasma for FC to potentially reduce unnecessary thyroidectomies and repeat invasive procedures. Methods: This study was a retrospective observational study, and included consecutively selected 90 patients who underwent thyroidectomy at Pusan National University Hospital between January 2013 and February 2024 and were diagnosed with FC (49 patients) or follicular thyroid adenoma (FA) (41 patients) on final histopathology. Of these, 58 patients were enrolled in the utility assessment and 32 patients were included in the validation test. Among the 58 patients included in the utility assessment, microarray analysis was conducted on 15 patients who were randomly selected to identify novel plasma miRNAs. Next, TaqMan qRT-PCR was performed to evaluate the diagnostic utility of five plasma miRNAs and to develop a predictive model capable of predicting FC from FA using logistic regression as the utility assessment on 58 patients. Finally, in the validation test, TaqMan qRT-PCR and statistical analysis were conducted again on 32 patients and the constructed predictive models, verifying the accuracy of the predictive model. Results: Using microarray analysis, a novel miRNA, miR-6085, was identified for its distinguishing capability between FC and FA. In the utility assessment, miR-6085, miR-146b-5p, miR-221, and miR-222 were significantly upregulated in the FC group. A predictive model combining these four miRNAs showed strong diagnostic value for FC, with an AUC of 0.928 (0.843, 1.000), sensitivity of 94.7% (84.2, 100), specificity of 86.4% (68.2, 100). The accuracy of this model was 76.2% (52.8, 91.8) in the validation test. Conclusions: A model combining four miRNAs (miR-6085, miR-146b-5p, miR-221, and miR-222) demonstrated high sensitivity, specificity, and accuracy, suggesting that it could be a useful tool for differentiating FC from FA.
背景：滤泡状甲状腺癌（FC）约占所有甲状腺癌的10-15%。细针穿刺活检（FNA）难以诊断FC，使得诊断性甲状腺切除术成为标准方法。近期研究探索了循环microRNA在甲状腺癌诊断中的应用。本研究评估了血浆中循环miRNA对FC的诊断价值，以期减少不必要的甲状腺切除术和重复性有创操作。 方法：本研究为回顾性观察性研究，连续纳入2013年1月至2024年2月在釜山国立大学医院接受甲状腺切除术、最终组织病理学诊断为FC（49例）或滤泡状甲状腺腺瘤（FA）（41例）的90例患者。其中58例患者纳入效用评估，32例患者纳入验证测试。在参与效用评估的58例患者中，随机选取15例进行微阵列分析以鉴定新型血浆miRNA。随后采用TaqMan qRT-PCR技术评估五种血浆miRNA的诊断效用，并基于58例患者通过逻辑回归建立能够区分FC与FA的预测模型进行效用评估。最后在验证测试中，对32例患者及已构建的预测模型再次进行TaqMan qRT-PCR和统计分析，验证预测模型的准确性。 结果：通过微阵列分析鉴定出新型miRNA——miR-6085，其具备区分FC与FA的能力。在效用评估中，miR-6085、miR-146b-5p、miR-221和miR-222在FC组中显著上调。整合这四种miRNA的预测模型对FC显示出强大的诊断价值：曲线下面积（AUC）为0.928（0.843，1.000），敏感性94.7%（84.2，100），特异性86.4%（68.2，100）。该模型在验证测试中的准确率为76.2%（52.8，91.8）。 结论：整合四种miRNA（miR-6085、miR-146b-5p、miR-221和miR-222）的模型展现出高敏感性、高特异性和良好准确性，表明其可能成为区分FC与FA的有效工具。
Diagnostic Models for Predicting Follicular Thyroid Carcinomas Using Circulating Plasma MicroRNAs
肿瘤(癌症)患者之家