Multicentre Clinical Validation of the THYT1 Test for Predicting Distant Metastases in Papillary Thyroid Carcinoma
In brief
THYT1 test flagged up to 80% of papillary thyroid cancers that metastasized
In a multicenter validation cohort of 143 patients, the genetic signature identified up to 80% of papillary thyroid cancers linked to distant metastases and was associated with lower overall survival. It anticipated metastases at diagnosis, sometimes by 19 years, but the retrospective findings do not yet show whether using the test improves treatment decisions or outcomes.
- Journal
- Endocrine pathology (Q1)
- Published
- 21 October 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Benedetta Donati, Federica Torricelli, Cristian Ascione, Moira Ragazzi, Dario De Biase, Thais Maloberti, et al.
- PMID
- 42905357
- DOI
- 10.1007/s12022-026-09939-7
Why clinicians should know about it
- Picked for Pathology and Forensic Medicine (top studies of the week, 25 October 2026): Multicentre molecular prognostic test validation in thyroid carcinoma
Abstract
It has been recently demonstrated that papillary thyroid carcinomas (PTCs) that develop distant metastases are characterized by three genetic alterations: Chr1qamp, TERT_locusamp, TERT_promotermut. This signature, named THYT1, holds the potential as an early prognostic predictor to identify patients at risk for disease progression. To implement the use of this signature in clinical practice we first developed a droplet digital PCR approach for a faster and cost-effective detection of the THYT1 in PTCs, then we validated its performance in a retrospective monocentric case-control training cohort (N = 90) of PTCs and in a separated multicentric validation cohort (N = 143) of PTCs. We also investigated THYT1 feasibility in cytological pre-surgical thyroid smears. In the training set, THYT1 evaluation by ddPCR showed 93% rate of concordance with the THYT1 status previously determined and correctly identified THYT1-positive and THYT1-negative PTCs with a 96% sensitivity and a 92% specificity. In the validation cohort, THYT1 identified up to 80% of distantly metastatic PTCs and significantly correlated with reduced overall survival. THYT1 signature was effective in anticipating at diagnosis both synchronous and metachronous metastases in advance of up to 19 years. These data confirm that THYT1 is an easy-to-use, rapidly available prognostic test to help refining the selection of patients with indolent lesions that could be eligible for conservative treatment strategies.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.