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01-05-2020 | Ultrasound | Original Article

Suspicious ultrasound and clinicopathological features of papillary thyroid carcinoma predict the status of TERT promoter

Authors: Hui Shi, Le-Hang Guo, Yi-Feng Zhang, Hui-Jun Fu, Jia-Yi Zheng, Han-Xiang Wang, Chong-Ke Zhao, Hui-Xiong Xu

Published in: Endocrine | Issue 2/2020

Abstract

Purpose

To investigate the value of ultrasound (US) and clinicopathological features of papillary thyroid cancer (PTC) in predicting Telomerase Reverse Transcriptase (TERT) promoter mutations.

Methods

Preoperative US images of 351 surgically confirmed PTCs were evaluated in terms of PTCs size and US features. The basic clinicopathological features were also retrieved. Univariate and multivariate analyses were performed to identify the risk factors for TERT promoter mutations. A scoring system was developed based on the cumulative number of risk factors. The area under the receiver operating characteristic curve (AUC) and cut-off value were calculated to evaluate the diagnostic performance of the scoring system for predicting TERT promoter mutations.

Results

TERT promoter mutations were found in 4.84% (17/351) of patients with PTCs. Patient age >50 years (OR: 6.244, P = 0.006), multifocality (OR: 21.071, P = 0.022), taller-than-wide shape (OR: 4.934, P = 0.029), microlobulated margin (OR: 4786, P = 0.032), and capsule contact or involvement (OR: 4.668, P = 0.030) were independent risk factors for TERT promoter mutations. TERT promoter mutations were relevant to more suspicious US and clinicopathological features than TERT promoter wild-type PTC (median, 4 vs. 1, P < 0.001). The cut-off value was 2.5 and the associated AUC was 0.908 (P < 0.001).

Conclusions

The probability of TERT promoter mutations increases along with the suspicious US features and clinicopathological characteristics, which may help to recognize patients who deserve a different approach, in terms of management and follow-up, in view of the worst outcome associated to this mutation.

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Title: Suspicious ultrasound and clinicopathological features of papillary thyroid carcinoma predict the status of TERT promoter
Authors: Hui Shi
Le-Hang Guo
Yi-Feng Zhang
Hui-Jun Fu
Jia-Yi Zheng
Han-Xiang Wang
Chong-Ke Zhao
Hui-Xiong Xu
Publication date: 01-05-2020
Publisher: Springer US
Keywords: Ultrasound
Ultrasound
Thyroid Cancer
Thyroid Cancer
Thyroid Cancer
Published in: Endocrine / Issue 2/2020
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-020-02214-7

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