A recent study has found a noninvasive test that looks for “molecular fingerprint in needle biopsies” for thyroid cancer diagnosis and can significantly reduce the number of unnecessary surgeries.
Thyroid is a gland situated at the base of the throat that plays a major role in the normal functioning of the endocrine system. With the help of iodine, thyroid releases hormones that regulate metabolic activity, heart rate, body temperature and blood pressure.
Over the years, the number of thyroid cancer patients have increased. According to the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute (NCI), since 1992, the number of diagnoses have risen from 6 to more than 14 per 100,000. The institute also estimated around 822,242 people living in the US, had thyroid cancer in 2016.
The study, published in PNAS, described the newly devised test and its results in a pilot study. The results showed an increase in efficiency and accuracy as compared to the traditional methods. “The findings showed the new method to be faster and around two-thirds more accurate than those that doctors currently rely on to diagnose thyroid cancer.”
Traditionally, the procedure begins with a biopsy of the gland by fine needle aspiration (FNA) technique. The sample is the then examined by pathologists to see if it is cancerous. However, the analysis might yield inaccurate results – about 1 in 5 FNA tests cannot confirm the presence of the cancer.
Due to the uncertainties in the tests, doctors often suggest complete or partial removal of the gland. To prevent such unnecessary surgeries, researchers have developed a new method to identify the presence of cancerous cells.
The team used mass spectrometry imaging to develop a molecular profile, or a fingerprint of the cancerous sample. This helped them identify the chemical byproducts/ metabolites of the cancerous cell activity. Molecular profiles from tissues of 178 people with or without thyroid cancer were examined to determine which metabolites to include in the standard fingerprint.
A trial to measure the accuracy of the test was carried out and involved 68 participants who had undergone FNA tests. Nearly 1/3rd of the volunteers had received inconclusive FNA results.
The findings revealed that the new technology produced false-positive results in around 1 in 10 cases – which was significantly more accurate than the FNA tests. “A test with this level of accuracy could have kept 17 study participants from undergoing unnecessary surgery”.
The researchers are now working on carrying the test on a larger group of patients to validate the findings. According to Dr. James W. Suliburk, associate professor and chief of endocrine surgery at Baylor College of Medicine, in Houston, TX, “With this next generation test we can provide thyroid cancer diagnoses faster and with more precision than current techniques — this will be the new state-of-the-art.” He further added, “We are able to do this analysis directly on the FNA sample and much more rapidly than the current process, which could take between 3 and 30 days”.