Improving predicted risk of recurrence using molecular profiling in papillary thyroid cancer

Cancer research · Thyroid cancer · BRAF · TP53

Molecular profiling can refine prediction of recurrence risk in papillary thyroid cancer, revealing sex‑dependent TNFα and estrogen signaling pathways that influence recurrence.

Molecular testing can refine the prediction of cancer recurrence. We compared gene expression in 8 patients with recurrence and 8 without recurrence of well‑differentiated papillary thyroid cancer, all clinically high risk, using RNA‑seq of archival tumor samples. Differential expression analysis identified 1,857 genes, with enrichment of anaplastic and poorly differentiated thyroid cancer signatures in recurrent tumors. Gene set enrichment and Ingenuity pathway analyses revealed sex‑dependent activation of TNFα signaling and estrogen response pathways: TNFα was activated in females and inhibited in males, while estradiol pathways showed the opposite pattern. A predictive model based on TCGA data yielded an AUC of 0.88 in external validation, outperforming standard clinical parameters. These findings demonstrate that sex‑specific molecular signatures can improve prognostication of recurrence in papillary thyroid cancer.

Sex‑specific molecular pathways identified in papillary thyroid cancer recurrence can enhance risk stratification, potentially sparing low‑risk patients from overtreatment and guiding more personalized therapy.

Evidence level: Állatkísérletes. Állatmodellben vizsgálták.

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