title: Measurement of thyroglobulin mRNA in peripheral blood as an adjunctive test for monitoring thyroid cancer.
abstract: OBJECTIVE
  Monitoring treated patients with thyroid cancer for recurrent or metastatic disease is currently based upon the serial measurement of circulating plasma thyroglobulin (Tg) concentrations. However, the clinical usefulness of Tg immunoassays is limited by poor sensitivity and interference from anti-Tg antibodies. This study investigated whether the detection of Tg mRNA in peripheral blood, using reverse transcriptase polymerase chain reaction (RT-PCR), is of value in the biochemical surveillance of patients with thyroid cancer.
  
  
  METHODS
  RNA was extracted from peripheral blood of five normal controls, six patients with abnormal thyroid function tests, and 28 patients who had undergone thyroidectomy for well differentiated thyroid cancer. From each, an 87 bp product from base pair 262 to 348 in the cDNA sequence of the thyroglobulin gene was amplified by RT-PCR.
  
  
  RESULTS
  Tg mRNA was detected in normal individuals and patients with thyroid cancer. In the group of patients studied, identification of metastatic thyroid tissue by radioiodine scanning correlated better with Tg mRNA assay results than with serum Tg concentrations (accuracy 84% v 75%). No interference from circulating Tg antibodies was apparent. In patients studied prospectively over a 12 month period, there was a significant correlation between detectable Tg mRNA in peripheral blood and the presence or absence of metastatic disease, as demonstrated by radioiodine scanning.
  
  
  CONCLUSIONS
  These results suggest that detection of Tg mRNA in blood is a more sensitive marker for metastatic thyroid disease than Tg immunoassay, and appears to be unaffected by the presence of circulating anti-Tg antibodies.
authors.affiliation: Molecular Medicine Research Centre, Department of Biological Sciences, University of Warwick, Coventry CV4 7AL, UK. dgrammatopoulos@bio.warwick.ac.uk
authors.forename: D
authors.initials: D
authors.lastname: Grammatopoulos
authors.forename: Y
authors.initials: Y
authors.lastname: Elliott
authors.forename: S C
authors.initials: SC
authors.lastname: Smith
authors.forename: I
authors.initials: I
authors.lastname: Brown
authors.forename: R J
authors.initials: RJ
authors.lastname: Grieve
authors.forename: E W
authors.initials: EW
authors.lastname: Hillhouse
authors.forename: M A
authors.initials: MA
authors.lastname: Levine
authors.forename: M D
authors.initials: MD
authors.lastname: Ringel
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000175:diagnosis / Q000556:secondary; D000231:Adenocarcinoma, Papillary / Q000175:diagnosis / Q000556:secondary; D001323:Autoantibodies / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D009363:Neoplasm Proteins / Q000235:genetics / Q000276:immunology; D012333:RNA, Messenger / Q000097:blood*; D012334:RNA, Neoplasm / Q000097:blood*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013954:Thyroglobulin / Q000235:genetics* / Q000276:immunology; D013964:Thyroid Neoplasms / Q000097:blood*
chemical_list: D001323:Autoantibodies; D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D012333:RNA, Messenger; D012334:RNA, Neoplasm; D013954:Thyroglobulin