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Surgery. 2019 Nov 8. pii: S0039-6060(19)30584-7. doi: 10.1016/j.surg.2019.06.058. [Epub ahead of print]

A novel gene panel for prediction of lymph-node metastasis and recurrence in patients with thyroid cancer.

Author information

1
Department of Surgery, Division of General, Endocrine and Oncological Surgery, Tulane University School of Medicine, New Orleans, LA.
2
Department of Biochemistry and Molecular Biology, Tulane University School of Medicine, New Orleans, LA; Department of Global Biostatistics and Data Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA.
3
Department of Otolaryngology, Tulane University School of Medicine, New Orleans, LA.
4
Department of Urology, Tulane University School of Medicine, New Orleans, LA.
5
Department of Surgery, Division of General, Endocrine and Oncological Surgery, Tulane University School of Medicine, New Orleans, LA. Electronic address: ekandil@tulane.edu.

Abstract

BACKGROUND:

Although well-differentiated papillary thyroid cancer may remain indolent, lymph node metastases and the recurrence rates are approximately 50% and 20%, respectively. No current biomarkers are able to predict metastatic lymphadenopathy and recurrence in early stage papillary thyroid cancer. Hence, identifying prognostic biomarkers predicting cervical lymph-node metastases would prove very helpful in determining treatment.

METHODS:

The database of the Cancer Genome Atlas included 495 papillary thyroid cancer samples. Using this database, we developed a machine learning model to define a gene signature that could predict lymph-node metastasis (N0 or N1). Kruskal-Wallis tests, univariate and multivariate logistic and Cox regression models, and Kaplan-Meier analyses were performed to correlate the gene signature with clinical outcomes.

RESULTS:

We identified a panel of 25 genes and constructed a risk score that can differentiate N0 and N1 papillary thyroid cancer samples (P < .001) with a sensitivity of 86%, a specificity of 62%, a positive predictive value of 93%, and a negative predictive value of 42%. This panel represents an independent biomarker to predict metastatic lymphadenopathy (OR = 8.06, P < .001) specifically in patients with T1 lesions (OR = 7.65, P = .002) and disease-free survival (HR = 2.64, P = .043).

CONCLUSION:

This novel 25-gene panel may be used as a potential prognostic marker for accurately predicting lymph-node metastasis and disease-free survival in patients with early-stage papillary thyroid cancer.

PMID:
31711617
DOI:
10.1016/j.surg.2019.06.058

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