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Erschienen in: Endocrine 2/2017

14.06.2017 | Original Article

Ultrasonographic prediction of highly aggressive telomerase reverse transcriptase (TERT) promoter-mutated papillary thyroid cancer

verfasst von: Tae Hyuk Kim, Chang-Seok Ki, Soo Yeon Hahn, Young Lyun Oh, Hye Won Jang, Sun Wook Kim, Jae Hoon Chung, Jung Hee Shin

Erschienen in: Endocrine | Ausgabe 2/2017

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Abstract

Purpose

Telomerase reverse transcriptase promoter mutations are found in highly aggressive thyroid malignancies. Our aim was to define the ultrasonographic features of telomerase reverse transcriptase promoter-mutated papillary thyroid cancer and to evaluate their predictive performances.

Methods

Ultrasonographic findings were reviewed for 185 patients with surgically confirmed papillary thyroid cancer between 1994 and 2004. Genomic DNA to identify telomerase reverse transcriptase promoter mutations was extracted from archived surgical specimens. Logistic regression analysis was performed to compare clinical factors and ultrasonographic findings between telomerase reverse transcriptase promoter-mutated and wild-type papillary thyroid cancers.

Results

A telomerase reverse transcriptase promoter mutation was detected in 8.1% (15 of 185) of specimens from papillary thyroid cancer patients with a strong trend toward increasing age. Nonparallel orientation and microlobulated margin were independent ultrasonographic findings for predicting telomerase reverse transcriptase promoter-mutated papillary thyroid cancer in patients over 50 years (odds ratio 5.898, 95% confidence interval 1.092–31.851, P = 0.039 for orientation; odds ratio 5.813, 95% confidence interval 1.320–25.602, P = 0.020 for margin). Prevalence of telomerase reverse transcriptase promoter mutations increased to 50.0% in papillary thyroid cancer patients older than 50 years with both ultrasonographic findings and was 0% in patients without either finding. For identifying telomerase reverse transcriptase promoter-mutated papillary thyroid cancer, ultrasonographic had 64.3% sensitivity, 80.8% specificity, 50.0% positive predictive value and 88.4% negative predictive value.

Conclusions

Telomerase reverse transcriptase promoter-mutated papillary thyroid cancer could be suggested by the ultrasonographic features of nonparallel orientation and microlobulated margin in patients older than 50 years. Prebiopsy recognition of this unique ultrasonographic pattern would mandate the nodule fall into a “biopsy suggested” category.
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Metadaten
Titel
Ultrasonographic prediction of highly aggressive telomerase reverse transcriptase (TERT) promoter-mutated papillary thyroid cancer
verfasst von
Tae Hyuk Kim
Chang-Seok Ki
Soo Yeon Hahn
Young Lyun Oh
Hye Won Jang
Sun Wook Kim
Jae Hoon Chung
Jung Hee Shin
Publikationsdatum
14.06.2017
Verlag
Springer US
Erschienen in
Endocrine / Ausgabe 2/2017
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-017-1340-3

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