In-Office Ultrasonographic Evaluation of Neck Masses/Thyroid Nodules

Differentiation of benign thyroid nodules from malignant thyroid nodules through miR-205-5p and thyroid-stimulating hormone receptor mRNA

PURPOSE

This study was designed to determine the value of miR-205-5p and thyroid-stimulating hormone receptor (TSHR) mRNA in differentiating benign thyroid nodules from malignant thyroid nodules.

METHODS

A total of 67 patients with malignant thyroid nodules admitted to our hospital from October 2016 to March 2018 were enrolled in the malignant group, and 71 patients with benign thyroid nodules were enrolled in the benign group. Another 56 healthy individuals, as determined by physical examination, were enrolled in the control group. Quantitative real-time polymerase chain reaction (qRT-PCR) was adopted to determine the relative expression of miR-205-5p and TSHR mRNA in serum, and receiver operating characteristic (ROC) curves were used to analyze the diagnostic value of miR-205-5p and TSHR mRNA in thyroid nodules and their benignancy or malignancy. The correlation of miR-205-5p and TSHR mRNA with clinical data of the patients with thyroid carcinoma was analyzed, and multivariate logistic regression was used to analyze risk factors for lymph node metastasis of thyroid carcinoma. In addition, Pearson's test was used to analyze the relationship between miR-205-5p and TSHR mRNA in serum of patients with thyroid carcinoma.

RESULTS

The malignant group showed significantly higher expression of miR-205-5p and TSHR mRNA than the benign group and control group (both p <0.001), and the benign group showed significantly higher expression of these than the control group (p <0.01). miR-205-5p expression was related to tumor size, TNM staging, lymph node metastasis, capsular infiltration, and BRAF mutation (p <0.05), and TSHR mRNA expression was related to lymph node metastasis, capsular infiltration, BRAF mutation, and RAS mutation (p <0.05). Gender, number of lesions, capsular infiltration, miR-205-5p, and TSHR mRNA were independent risk factors for lymph node metastasis of patients with thyroid carcinoma. Moreover, there was a positive correlation between miR-205-5p and TSHR mRNA in patients with thyroid carcinoma (r=0.735, p<0.001).

CONCLUSION

MiR-205-5p and TSHR mRNA may be potential diagnosis indexes of thyroid nodules, their benignancy, or malignancy, while the independent risk factors for patients with thyroid carcinoma include a large number of lesions, occurrence of capsular infiltration, and relatively high expression of miR-205-5p and TSHR mRNA.

Ultrasound-guided fine-needle aspiration biopsy of thyroid nodules

Fine needle aspiration biopsy (FNAB) remains crucial in the evaluation of thyroid nodules with suspicious clinical findings or ultrasound (US) features suggestive of malignancy. The use of US-guidance for FNAB allows real-time visualization of the needle, but is also highly operator-dependent. Physicians from many specialties (endocrinologists, otolaryngologists/endocrine surgeons, nuclear medicine physicians, radiologists, and pathologists) are involved in the diagnostic workup of thyroid nodules and a standardized and meticulous technique for US-FNAB is essential for lowering the yield of nondiagnostic specimens and false-negative results. This video, therefore, demonstrates a well-proved technique and technical tips to increase the diagnostic results from US-FNAB.