title: Detection of circulating thyroid cancer cells in patients with thyroid microcarcinomas.
abstract: BACKGROUND
  Circulating thyroid cancer cells detected by peripheral blood thyroid-stimulating hormone receptor (TSHR) mRNA have demonstrated usefulness for thyroid cancer diagnosis and long-term surveillance. The aim of this study was to determine detectability and clinical importance of TSHR mRNA in patients with microcarcinomas.
  
  
  METHODS
  We compared clinical characteristics of 37 patients with papillary thyroid microcarcinomas (PTMC; tumor size </=1 cm) having undetectable (-) versus detectable (+)TSHR mRNA.
  
  
  RESULTS
  59 Of the PTMC patients, 59% had (+)TSHR mRNA levels, similar to those with tumors >1 cm (72%; P = NS) and distinctly higher than false (+) rates in benign goiters (15%; P < .001). All patients with (-)TSHR mRNA had classical PTMC, whereas variants (32%) occurred with (+)mRNA (P = .001). Mean tumor size (5 mm) and multifocality rates (45%) were similar in both mRNA groups. Of the PTMC patients, 35% had concurrent cervical nodal metastases, which occurred more frequently with tumors >/=5 mm (P = .04) and with (+)TSHR mRNA in pre-operatively known PTMC (P < .05). No patients with incidentally detected PTMC and (-)TSHR mRNA had metastases.
  
  
  CONCLUSIONS
  This study is the first to demonstrate that TSHR mRNA, reflecting circulating thyroid cancer cells, is detectable even with thyroid microcarcinomas. PTMC with (+)TSHR mRNA may characterize patients with potentially more aggressive histology at initial operation.
authors: Endocrine Surgery Department, Endocrinology and Metabolism Institute, The Cleveland Clinic, Cleveland, Ohio 44195, USA.
authors: Tomislav
authors: T
authors: Novosel
authors: Hadley E
authors: HE
authors: Ritter
authors: Manjula
authors: M
authors: Gupta
authors: Adrian
authors: A
authors: Harvey
authors: Jamie
authors: J
authors: Mitchell
authors: Eren
authors: E
authors: Berber
authors: Allan
authors: A
authors: Siperstein
authors: Mira
authors: M
authors: Milas
mesh_terms: D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000097:blood* / Q000235:genetics / Q000473:pathology / Q000556:secondary*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating / Q000378:metabolism / Q000473:pathology*; D011446:Prospective Studies; D012333:RNA, Messenger / Q000097:blood / Q000235:genetics; D012334:RNA, Neoplasm / Q000097:blood / Q000235:genetics; D011989:Receptors, Thyrotropin / Q000235:genetics; D013964:Thyroid Neoplasms / Q000097:blood* / Q000235:genetics / Q000473:pathology*; D055815:Young Adult
chemical_list: D012333:RNA, Messenger; D012334:RNA, Neoplasm; D011989:Receptors, Thyrotropin