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MOLECULAR MARKERS FOR WELL-DIFFERENTIATED THYROID CANCER
Summary. The determination of serum thyroglobulin (sTg) is considered as the most effective marker for post-operative follow-up in well differentiated thyroid cancer (DTC) and must be carried out together with whole-body radioiodine scanning and detection of antibodies to Tg. The detection of serum Tg mRNA has the most valued prognostic effect. Increase of the sTg level in pre-operative period could testify the occurence of follicular cancer or Hurtle-cell cancer. The detection of cytokeratin 20 and 19 mRNA is known to have good predictable value also. The detection of Tg and thyrotrophic hormone receptors by PCR has nearly 100% diagnostic effectiveness. The dynamic detection of calcitonin is known to serve as the most significant method for post-operative follow-up of medullary thyroid cancer (the detection of Ret mutation, CEA, chromogranin A serves as additional methods). The Ret/PTC expression in DTC tissues indicates the presence and the level of neoplastic transformation. The use of MoAb 47 and DAP in FNAB improves the results of diagnosis. The determination of E-cadherin/catenin adhesion complex, CK-19 and CK-20, galectin-3 and S-100 protein is effective for diagnosis of diffuse sclerosing variant. Low level of nm23-H1 expression and absence of p53 mutations are proving the low risk of DTC recurrence and of the development of metastases.
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