Ricerc@Sapienza

Thyroid follicular nodules are quite common in general population, however only a small proportion is malignant. Follicular thyroid cancer (FTC) differs from adenoma (FA) by features of cellular atypia, angioinvasiveness and possibility of metastasis via blood. There is no possibility to determine with certainty whether the lesion is benign or malignant before surgery. Moreover, follicular patterned nodules are complex to be classified due to ambiguous nuclear features also at histological examination.
In addition, a clear molecular profile able to discriminate FA from FTC is missing. There is only a pathway hypothesis for progression from FA to FC that still requires confirmatory studies and there aren't evidences about a possible malignant potential in lesions morphologically diagnosed as adenomas.

Raman spectroscopy (RS) is an emerging method able to analyze composite molecular configurations, providing fingerprint information on biological structures of the analyzed samples. We recently used RS to investigate histological samples from human thyroid. While RS has allowed to distinguish healthy tissues from cancerous ones and to discriminate with high accuracy major categories of thyroid cancer (papillary, follicular, papillary/follicular), the analyzed FA were spread by the cluster analysis over the four categories (Benign, PTC, FTC, FV-PTC).

The aim of the present study is to perform a deeply examination of the 5 identified FA falling in the Raman malignant cluster by a combined approach including clinical, morphological, immunohistochemical and mutational analysis through next-generation sequencing (NGS), and to compare the results with paired methods applied to FAs that fall in the Raman benign cluster (n=5).

Results are expected to assess early molecular alteration likely related to ongoing malignant transformation, thus differentiating non-evolving benign tumors from the ones with identical morphology that may require surgical management.