A systematic review of emerging RNA markers in thyroid fine needle aspiration cytology samples: advancements and challenges.

BACKGROUND

Significant advances have been made in detecting RNA markers that may indicate malignancy in fine needle aspiration cytology (FNAC) samples.

OBJECTIVE

To review the roles of protein-coding and non-coding RNAs in differentiating between malignant and benign thyroid nodules.

METHODS

A comprehensive literature search using PubMed, Science Direct, Web of Science, and SCOPUS databases was performed. We searched up until September 2024 and complemented by manual citation search.

RESULTS

A total of 28 full-text articles were reviewed, encompassing 5770 FNAC samples, which included 3489 benign lesions and 2281 malignant lesions. The studies identified 43 messenger RNAs (mRNAs), 16 microRNAs (miRNAs), and 3 long non-coding RNAs (lncRNAs) that have the potential to distinguish malignant nodules. Among the mRNAs, PAPPA, TIMP1, and HMGA2, as well as the miRNAs, miR-146b, miR-375 and miR-222, appear to be the most promising molecules for diagnosis.

CONCLUSION

Numerous RNA markers have been shown to differentiate malignant from benign lesions. However, there is still a lack of patient-specific classification for thyroid cancer subtypes. Additionally, future studies should prioritize using a combination of molecular markers rather than relying on individual ones. Although current research mainly focuses on identifying cancer-specific molecules, it is important for future studies to shift towards a more patient-specific approach.