Evidence map›Paper›PMID 39787026›Full record

ArticleBJS open2024

Circulating large extracellular vesicles as diagnostic biomarkers of indeterminate thyroid nodules: multi-platform omics analysis.

Nada M Ahmed, Mohammad M R Eddama, Kevin Beatson, Rijan Gurung, Jigisha Patel, Georges Iskandar, Alaa Abdel-Salam, Abdullah Al-Omar, Richard Cohen, Tarek Abdel-Aziz and 1 more

Abstract read
In one paragraph

Article in BJS open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Review
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Nada M AhmedInstitute of Cardiovascular Sciences, University College London, London, UK.ORCID 0000-0002-2849-9961
Mohammad M R EddamaDepartment of Surgical Biotechnology, Division of Surgery and Interventional Science, University College London, London, UK.ORCID 0000-0002-4582-0788
Kevin BeatsonDepartment of Surgical Biotechnology, Division of Surgery and Interventional Science, University College London, London, UK.ORCID 0000-0001-5824-5009
Rijan GurungDepartment of Surgical Biotechnology, Division of Surgery and Interventional Science, University College London, London, UK.
Jigisha PatelDepartment of Surgical Biotechnology, Division of Surgery and Interventional Science, University College London, London, UK.
Georges IskandarDepartment of Anaesthesia and Perioperative Medicine, University College London Hospitals, London, UK.
Alaa Abdel-SalamEndocrine Surgery Unit, University College London Hospitals, London, UK.ORCID 0009-0008-7990-6302
Abdullah Al-OmarEndocrine Surgery Unit, University College London Hospitals, London, UK.
Richard CohenDepartment of Surgical Biotechnology, Division of Surgery and Interventional Science, University College London, London, UK.
Tarek Abdel-AzizEndocrine Surgery Unit, University College London Hospitals, London, UK.ORCID 0000-0001-7630-9985
Lucie ClappInstitute of Cardiovascular Sciences, University College London, London, UK.

Funding

Charity Grant 534982Egyptian missions' sector award MM42/19UCLHUniversity College Hospital Charity 172627)
6 · The paper itself

Abstract

backgroundWhile most thyroid nodules are benign, 7-15% are malignant. Patients with indeterminate thyroid nodules (specifically Bethesda IV/Thy3f) often undergo diagnostic hemithyroidectomy to reach a diagnosis on final histology. The aim of this study was to assess the feasibility of circulating large extracellular vesicles as diagnostic biomarkers in patients presenting with Thy3f thyroid nodules.

methodsThis was a two-gate diagnostic accuracy study; patients with Thy3f thyroid nodules were age, sex and body mass index matched to healthy individuals. Final histology confirmed benign and malignant diagnoses. Plasma large extracellular vesicle counts were quantified using flow cytometry. Large extracellular vesicle microRNA and protein profiles were identified using next generation sequencing and mass spectrometry, respectively.

resultsA total of 42 patients with Thy3f nodules (22 with cancer, 20 with non-cancer diagnosis) and 16 healthy controls were included. Total large extracellular vesicle concentrations and the concentrations of extracellular vesicles expressing epithelial cell adhesion molecule and the cancer markers atypical chemokine receptor type 7, extracellular matrix metalloproteinase inducer and syndecan-4 were significantly higher in patients with Thy3f nodules (cancer and non-cancer) compared with healthy individuals. In patients with cancerous versus non-cancer Thy3f nodules, one microRNA was upregulated: mir-195-3p (P < 0.001). Five were downregulated: mir-3176 (P < 0.001), mir-205-5p (P < 0.001), novel-hsa-mir-208-3p (P < 0.001), mir-3529-3p (P = 0.01) and let-7i-3p (P = 0.02). Furthermore, three large extracellular vesicle proteins (kallikrein-related peptidase11 (KLK11) (P = 0.001), alpha-1-acid glycoprotein 2 (A1AG2) (P <0.001) and small integral membrane protein 1 (SMIM1) (P = 0.04)) were significantly upregulated, while 20 large extracellular vesicle proteins were significantly downregulated (most downregulated: chemokine (C-X-C motif) ligand 7 (CXCL7), tubulin beta chain 1 (TBB1), binding immunoglobulin protein (BIP) and actinin alpha 1 (ACTN1) (P < 0.001)) in cancerous compared with non-cancer Thy3f nodules.

conclusionCirculating large extracellular vesicle miRNA and protein profiles have a high diagnostic value to discriminate between benign and malignant nodules for patients with Thy3f cytology. Further validation for clinical performance will be needed.

Indexed as

Biomarkers, TumorExtracellular VesiclesMicroRNAsThyroid NoduleAdultAgedCase-Control StudiesFemaleHumansMaleMiddle AgedThyroid NeoplasmsBiomarkers, TumorMicroRNAs

Identifiers

PMID39787026
PMCPMC11683363

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.