High-throughput gene expression analysis of the extrathyroidal process and search for recurrence prediction algorithms in patients with papillary thyroid carcinoma treated with surgery and radioiodine therapy

Abstract

Papillary thyroid carcinoma is one of the most frequent malignant endocrine neoplasia and increasing in prevalence in the last decades. The prognostic is usually favorable nevertheless death risk stratification is essential to determine treatment aggressiveness and the level of vigilance for the patient. Among the most important factors used to determine the risks of recurrence or death risk by the disease is extrathyroidal extension. After thyroidectomy, radioiodine therapy is frequently indicated, which helps the post-operative following and reduces the risk of death by disease. In this study, we will perform expression oligoarrays analysis on papillary thyroid carcinoma with or without extrathyroidal extension, the first one considered as more aggressive. The aim of this analysis is to identify essential factors of tumor progression from initial stages to more aggressive. The prevalence of common mutations in this type of neoplasia (in RAS and BRAF) will be evaluated according to extrathyroidal extension status. In addition, the importance of the participation of iodine incorporation pathways on recurrence after radioiodine therapy will be evaluated, using immunohistochemistry in a platform of tissue microarray (TMA). Through the integration of clinical and molecular data, algorithms aiming to predict disease recurrence will be elaborated. The markers and models established will be evaluated in independent sets of validation by transcriptional and protein expression assays. (AU)