INTERNATIONAL CONGRESS OF
CancerGenetics
The clinical value of Biomarkers in papillary thyroid carcinoma Detection
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negar shirani,1,*
1. lorestan medical university
- Introduction: Thyroid cancer is one of the most prevalent malignant endocrine cancer worldwide. The most common form of thyroid malignancy, PTC accounts for 80-85% of all thyroid malignancies. Despite its frequency detecting PTC from benign thyroid cancer is challenging due to its clinical signs overlap. Early and accurate diagnosis is essential for improvement patient outcomes, emphasizing the need for reliable biomarkers for PTC monitor. It has been observed that several tumor markers are associated with clinical utilities in the diagnosis, monitoring, and prognosis of PTC. In this review, we discuss key biomarkers, their roles in the clinical practice being: 1) Thyroglobulin Thyroglobulin (Tg) is a highly sensitive and specific tumor marker in patients who have undergone total thyroidectomy for PTC. Serum Tg levels are an effective and useful tumor marker for PTC. Postoperative serum Tg value is an important prognostic factor that is used to guide clinical management and is the most valuable tool in the long-term follow-up of patients with PTC However, the accuracy of Tg assays can be compromised by the presence of thyroglobulin antibodies (TgAb), which interfere with the measurement of Tg levels, rendering them unreliable in some patients 2) CA19-9 CA19-9 is traditionally used as a marker for gastrointestinal tumors, particularly pancreatic cancer . , recent studies suggest that it may have potential as a biomarker for PTC in cases where thyroglobulin levels are unreliable due to TgAb interference. Unlike Tg, CA19-9 levels are unaffected by TgAb, CA19-9 offers an alternative for patients with TgAb, as it is unaffected by TgAb levels. It could serve as a surrogate marker in cases where traditional monitoring with Tg is not feasible Pathological examination including immunohistochemistry (IHC) has been a gold standard for PTC diagnosis and predicting outcomes in PTC. Biomarkers such as BRAF V600E, Cytokeratin 19 (CK-19), and Galectin-3 (Gal-3) proteins’ expressions, as determined by IHC, are approved. Therefore, Number of studies have confirmed that the expression of CK-19 was generally increased in malignant thyroid conditions 3) NrF2 Recent research has identified Nrf2 as a novel biomarker with significant clinical implications in PTC. Nrf2 is highly expressed in papillary thyroid carcinoma tissue compared to adjacent normal tissue and nodular goiter tissues. The increased expression of Nrf2 was significantly associated with PTC and suggests that Nrf2 could serve as a valuable biomarker for diagnosing PTC with a high sensitivity The study also showed that Nrf2 expression was significantly higher in patients with lymph node metastasis (LNM). This indicates that Nrf2 could be used not only to diagnose PTC but also as a predictive marker for the likelihood of lymph node metastasis, with a sensitivity of 96% and specificity of 88.57% thorough western blot, qPCR, FIA, ELISA etc.
- Methods: western blot, qPCR, FIA, ELISA etc
- Results: While CA19-9 represent an alternative approach to the Tg measurement, in cases where Tg levels are interfered by TgAb, Nrf2 offers larger diagnostic and prognostic capability. Particularly for detecting lymph node metastasis and and relation with other relevant biomarkers. Additionally, the variety of detection methods available for Nrf2 enhances its clinical utility and versatility compared to the limited detection techniques available for CA19-9. Ultimately, Nrf2 would provide a more comprehensive diagnostic and prognostic approach in PTC management and thus represents a promising complement or alternative to conventional biomarkers such as CA19-9 and Tg
- Conclusion: Currently, tg is used more in clinical studies, but in the future, clinical biomarkers that are more accurate and effective both before and after surgery will definitely be used.
- Keywords: papillary thyroid carcinoma – Biomarkers- Thyroglobulin- CA19-9- NrF2
