Skip to main content Skip to main navigation menu Skip to site footer

Combination of thyroid ultrasound examination (TIRADS) and survivin gene mRNA expression to determine the type of thyroid nodule



Abstract

Background: Ultrasound plays a significant role in determining the diagnosis of thyroid nodules. The thyroid ultrasound examination is operator dependent, so the Thyroid Imaging Reporting and Data System (TIRADS) method were developed. However, until now TIRADS has not been able to replace the Fine Needle Aspiration (FNA) examination in determining the type of benign or malignant thyroid nodule, so it is necessary to find alternative biomarkers that can be used to increase the sensitivity and specificity of TIRADS. In this study, the mRNA expression of the survivin gene in thyroid nodules was examined in combination with TIRADS so that it is expected to increase the diagnostic value.

Method: This study is a diagnostic test with a cross sectional design on 51 patients with thyroid nodules in 5 hospitals on the island of Lombok. Subjects who met the inclusion and exclusion criteria were subjected to TIRADS examination using an ultrasound machine and mRNA expression of the survivin gene using cubital vein blood samples with polymerase chain reaction (PCR).

Result: The characteristics of the research subjects were dominated by female sex with age 40 years, TIRADS 3 and histology of benign thyroid nodules. Analysis using the ROC curve obtained TIRADS has a sensitivity of 94.4%, specificity 39.4%, accuracy 58.82%, Positive Predictive Value (PPV) 45.9%, Negative Predictive Value (NPV) 92.9%. While Survivin has 100% sensitivity, 60.6% specificity, 58.1% accuracy, 58.1% PPV, 100% NPV. In the serial combination of TIRADS and survivin, there was an increase in the diagnostic value, namely sensitivity 94.4%, specificity 75.8%, accuracy 82.35%, PPV 68%, NPV 96.2%.

Conclusion: The combination of TIRADS and survivin can increase the diagnostic value in determining the type of thyroid nodule

Keywords: TIRADS survivin diagnostic test accuracy

References

  1. Durante C, Grani G, Lamartina L, Filetti S, Mandel SJ, Cooper DS. The Diagnosis and Management of Thyroid Nodules. JAMA [Internet]. 2018;319(9):914. Available from: http://dx.doi.org/10.1001/jama.2018.0898
  2. Grant EG, Tessler FN, Hoang JK, Langer JE, Beland MD, Berland LL, et al. Thyroid Ultrasound Reporting Lexicon: White Paper of the ACR Thyroid Imaging, Reporting and Data System (TIRADS) Committee. J Am Coll Radiol [Internet]. 2015;12(12):1272–9. Available from: http://dx.doi.org/10.1016/j.jacr.2015.07.011
  3. Horvath E, Majlis S, Rossi R, Franco C, Niedmann JP, Castro A, et al. An Ultrasonogram Reporting System for Thyroid Nodules Stratifying Cancer Risk for Clinical Management. J Clin Endocrinol & Metab [Internet]. 2009;94(5):1748–51. Available from: http://dx.doi.org/10.1210/jc.2008-1724
  4. Tessler FN, Middleton WD, Grant EG, Hoang JK, Berland LL, Teefey SA, et al. ACR Thyroid Imaging, Reporting and Data System (TI-RADS): White Paper of the ACR TI-RADS Committee. J Am Coll Radiol [Internet]. 2017;14(5):587–95. Available from: http://dx.doi.org/10.1016/j.jacr.2017.01.046
  5. Tessler FN, Middleton WD, Grant EG. Thyroid Imaging Reporting and Data System (TI-RADS): A User’s Guide. Radiology [Internet]. 2018;287(1):29–36. Available from: http://dx.doi.org/10.1148/radiol.2017171240
  6. Mahmoudian-Sani MR, Alghasi A, Saeedi-Boroujeni A, Jalali A, Jamshidi M, Khodadadi A. Survivin as a diagnostic and therapeutic marker for thyroid cancer. Pathol - Res Pract [Internet]. 2019;215(4):619–25. Available from: http://dx.doi.org/10.1016/j.prp.2019.01.025
  7. Thomas S, Shah GM. Calcitonin induces apoptosis resistance in prostate cancer cell lines against cytotoxic drugs via the Akt/Survivin pathway. Cancer Biol & Ther [Internet]. 2005;4(11):1226–33. Available from: http://dx.doi.org/10.4161/cbt.4.11.2093
  8. Selemetjev SA, Savin SB, Paunovic IR, Tatic SB, Cvejic D. Changes in the expression pattern of apoptotic molecules (galectin-3, Bcl-2, Bax, survivin) during progression of thyroid malignancy and their clinical significance. Wien Klin Wochenschr [Internet]. 2014;127(9–10):337–44. Available from: http://dx.doi.org/10.1007/s00508-014-0674-6
  9. Jaiswal PK, Goel A, Mittal RD. Survivin: A molecular biomarker in cancer. Indian J Med Res [Internet]. 2015 Apr;141(4):389–97. Available from: https://pubmed.ncbi.nlm.nih.gov/26112839
  10. Chen Z, Liu N, Zhu G, Dralle H, Hoang-Vu C. Targeting of the anti-apoptotic gene survivin in human thyroid carcinoma. Int J Mol Med [Internet]. 2012/06/28. 2012 Sep;30(3):465–72. Available from: https://pubmed.ncbi.nlm.nih.gov/22751750

How to Cite

Ma’ruf, F., Suanjaya, M. A. ., Murtala, B. ., Ilyas, M., Hatta, M. ., Mulyadi, R. ., Natzir, R. ., Idris, I. ., Cangara, M. H. ., Muis, M. ., Zainuddin, A. A. ., Anjarwati, D. ., & Wiwik Suri Aprianturi. (2022). Combination of thyroid ultrasound examination (TIRADS) and survivin gene mRNA expression to determine the type of thyroid nodule. Bali Medical Journal, 11(2), 1030–1034. https://doi.org/10.15562/bmj.v11i2.3551
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX

HTML
3

Total
16

Share