Hui Shi1,2,3, Le-Hang Guo1,2,3, Yi-Feng Zhang1,2,3, Hui-Jun Fu2,3,4, Jia-Yi Zheng2,3,4, Han-Xiang Wang1,2,3, Chong-Ke Zhao5,6,7, Hui-Xiong Xu8,9,10. 1. Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University Cancer Center, Tongji University School of Medicine, Shanghai, 200072, China. 2. Thyroid Institute, Tongji University School of Medicine, Shanghai, 200072, China. 3. Shanghai Center for Thyroid Diseases, Shanghai, 200072, China. 4. Department of Pathology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, China. 5. Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University Cancer Center, Tongji University School of Medicine, Shanghai, 200072, China. zhaochongke123@163.com. 6. Thyroid Institute, Tongji University School of Medicine, Shanghai, 200072, China. zhaochongke123@163.com. 7. Shanghai Center for Thyroid Diseases, Shanghai, 200072, China. zhaochongke123@163.com. 8. Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Tongji University Cancer Center, Tongji University School of Medicine, Shanghai, 200072, China. xuhuixiong@126.com. 9. Thyroid Institute, Tongji University School of Medicine, Shanghai, 200072, China. xuhuixiong@126.com. 10. Shanghai Center for Thyroid Diseases, Shanghai, 200072, China. xuhuixiong@126.com.
Abstract
PURPOSE: To investigate the value of ultrasound (US) and clinicopathological features of papillary thyroid cancer (PTC) in predicting Telomerase Reverse Transcriptase (TERT) promoter mutations. METHODS: Preoperative US images of 351 surgically confirmed PTCs were evaluated in terms of PTCs size and US features. The basic clinicopathological features were also retrieved. Univariate and multivariate analyses were performed to identify the risk factors for TERT promoter mutations. A scoring system was developed based on the cumulative number of risk factors. The area under the receiver operating characteristic curve (AUC) and cut-off value were calculated to evaluate the diagnostic performance of the scoring system for predicting TERT promoter mutations. RESULTS: TERT promoter mutations were found in 4.84% (17/351) of patients with PTCs. Patient age >50 years (OR: 6.244, P = 0.006), multifocality (OR: 21.071, P = 0.022), taller-than-wide shape (OR: 4.934, P = 0.029), microlobulated margin (OR: 4786, P = 0.032), and capsule contact or involvement (OR: 4.668, P = 0.030) were independent risk factors for TERT promoter mutations. TERT promoter mutations were relevant to more suspicious US and clinicopathological features than TERT promoter wild-type PTC (median, 4 vs. 1, P < 0.001). The cut-off value was 2.5 and the associated AUC was 0.908 (P < 0.001). CONCLUSIONS: The probability of TERT promoter mutations increases along with the suspicious US features and clinicopathological characteristics, which may help to recognize patients who deserve a different approach, in terms of management and follow-up, in view of the worst outcome associated to this mutation.
PURPOSE: To investigate the value of ultrasound (US) and clinicopathological features of papillary thyroid cancer (PTC) in predicting Telomerase Reverse Transcriptase (TERT) promoter mutations. METHODS: Preoperative US images of 351 surgically confirmed PTCs were evaluated in terms of PTCs size and US features. The basic clinicopathological features were also retrieved. Univariate and multivariate analyses were performed to identify the risk factors for TERT promoter mutations. A scoring system was developed based on the cumulative number of risk factors. The area under the receiver operating characteristic curve (AUC) and cut-off value were calculated to evaluate the diagnostic performance of the scoring system for predicting TERT promoter mutations. RESULTS:TERT promoter mutations were found in 4.84% (17/351) of patients with PTCs. Patient age >50 years (OR: 6.244, P = 0.006), multifocality (OR: 21.071, P = 0.022), taller-than-wide shape (OR: 4.934, P = 0.029), microlobulated margin (OR: 4786, P = 0.032), and capsule contact or involvement (OR: 4.668, P = 0.030) were independent risk factors for TERT promoter mutations. TERT promoter mutations were relevant to more suspicious US and clinicopathological features than TERT promoter wild-type PTC (median, 4 vs. 1, P < 0.001). The cut-off value was 2.5 and the associated AUC was 0.908 (P < 0.001). CONCLUSIONS: The probability of TERT promoter mutations increases along with the suspicious US features and clinicopathological characteristics, which may help to recognize patients who deserve a different approach, in terms of management and follow-up, in view of the worst outcome associated to this mutation.
Authors: João Vinagre; Ana Almeida; Helena Pópulo; Rui Batista; Joana Lyra; Vasco Pinto; Ricardo Coelho; Ricardo Celestino; Hugo Prazeres; Luis Lima; Miguel Melo; Adriana Gaspar da Rocha; Ana Preto; Patrícia Castro; Ligia Castro; Fernando Pardal; José Manuel Lopes; Lúcio Lara Santos; Rui Manuel Reis; José Cameselle-Teijeiro; Manuel Sobrinho-Simões; Jorge Lima; Valdemar Máximo; Paula Soares Journal: Nat Commun Date: 2013 Impact factor: 14.919
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Authors: Mingzhao Xing; Ali S Alzahrani; Kathryn A Carson; Young Kee Shong; Tae Yong Kim; David Viola; Rossella Elisei; Bela Bendlová; Linwah Yip; Caterina Mian; Federica Vianello; R Michael Tuttle; Eyal Robenshtok; James A Fagin; Efisio Puxeddu; Laura Fugazzola; Agnieszka Czarniecka; Barbara Jarzab; Christine J O'Neill; Mark S Sywak; Alfred K Lam; Garcilaso Riesco-Eizaguirre; Pilar Santisteban; Hirotaka Nakayama; Roderick Clifton-Bligh; Giovanni Tallini; Elizabeth H Holt; Vlasta Sýkorová Journal: J Clin Oncol Date: 2014-10-20 Impact factor: 44.544