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Clinical Cancer Research Vol. 9, 1792-1800, May 2003
© 2003 American Association for Cancer Research


Molecular Oncology, Markers, Clinical Correlates

Classification of Follicular Thyroid Tumors by Molecular Signature

Results of Gene Profiling1

Catherine B. Barden, Katherine W. Shister, Baixin Zhu, Gerardo Guiter, David Y. Greenblatt, Martha A. Zeiger and Thomas J. Fahey, III2

Departments of Surgery [C. B. B., K. W. S., B. Z., D. Y. G., T. J. F.] and Pathology [G. G.], New York Presbyterian Hospital and Weill Medical College of Cornell University, New York, New York 10021; and Johns Hopkins University School of Medicine, Baltimore, Maryland [M. A. Z.]; and Strang Cancer Prevention Center, New York, New York [T. J. F.]

Purpose: Thyroid nodules are common, with a lifetime risk of developing a clinically significant thyroid nodule of 10% or higher. Preoperative diagnosis was greatly enhanced by the introduction of fine needle aspiration in the 1970s, but there has been little advancement since that time. Discrimination between benign and malignant follicular neoplasms is currently not possible by fine needle aspiration and can even be difficult after full pathologic review. The purpose of these studies is to identify genes expressed in follicular adenomas and carcinomas of the thyroid that will permit molecular differentiation of these neoplasms.

Experimental Design: Gene expression patterns of 17 thyroid follicular tumors were analyzed by oligonucleotide array analysis. Gene profiles for follicular adenomas and carcinomas were identified, and the two groups were compared for differences in expression levels. The differentially expressed genes were used to perform a hierarchical clustering analysis training set. Five follicular tumors with diagnosis undisclosed to the investigators and 2 minimally invasive carcinomas were entered into the cluster analysis as a test set to determine whether diagnosis by gene profile correlated with that obtained by pathologic evaluation.

Results: Thyroid follicular adenomas and carcinomas showed strikingly distinct gene expression patterns. The expression patterns of 105 genes were found to be significantly different between follicular adenoma and carcinoma. Many uncharacterized genes contributed to the distinction between tumor types. For five follicular tumors for which the final diagnosis was undisclosed, the clustering algorithm gave the correct diagnosis in all 5 cases.

Conclusions: Gene profiling is a useful tool to predict the molecular diagnosis of follicular thyroid tumors. Genes were identified that reliably differentiate follicular thyroid carcinoma from adenoma. This study provides insight into genes that may be important in the molecular pathogenesis of follicular thyroid tumors, as well candidates for preoperative diagnosis of follicular thyroid carcinoma.




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Molecular Cancer Research Cancer Prevention Research
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Copyright © 2003 by the American Association for Cancer Research.