A multidisciplinary study at Vall d'Hebron University Hospital has won the award for the best original article of 2021 published in the journal Endocrinología, Diabetes y Nutrición. The research has presented a new strategy to predict papillary thyroid cancer affectation on the lymph nodes through molecular analysis. Knowing this affectation is crucial in indicating the likelihood of metastasis and/or recurrence of this disease. The prize was awarded by the Spanish Society of Endocrinology and Nutrition (SEEN), which is the editor of the journal. The clinical research was led by Dr. Carmela Iglesias, assistant of the Anatomic Pathology Service of Vall d'Hebron and researcher of the Translational Molecular Pathology research group of the Vall d'Hebron Research Institute.

The goal of this multidisciplinary research was to find a more accurate method for selecting papillary thyroid cancers that are more likely to have a significant metastatic load in the lymph nodes at the time of surgery. Until recently it was assumed that the existence of metastatic lymph nodes alone increased the chances of recurrence, but new research has proven that it is the amount of tumor burden present in the nodes, not their existence, that determines the risk of relapse. However, no internationally accepted method of measuring this load has yet been found. In this study, we have proposed to measure the copies of the cytokeratin-19 present in suspicious lymphoid tissues using the one-step nucleic acid amplification technique (OSNA). Cytokeratin-19 is considered a reliable marker of papillary carcinoma involvement.

A total of 550 nodes were analyzed and the results were compared with those of a cytology performed in parallel. The nodes were also categorized by their diameter and the dimension of their metastatic tissue. Regarding size, it has been shown that metastatic nodes larger than 3 cm have a higher tumor burden than smaller ones. However, below this size, there is no significant correlation between dimension and burden. OSNA was shown to provide a quantitative measurement that can overcome the limitations of the current analysis. Even so, the parallel cytological study cannot be eliminated, since it ensures the lymphatic nature of the lymph node, avoiding false positives. Another highlight of the new method is that it makes it possible to quantify the total metastatic burden in the lymph node and not only to measure the burden of the largest focus.

The Spanish Society of Endocrinology and Nutrition (SEEN) is a scientific society composed of Endocrinologists, Biochemists, Biologists and other professionals working in the field of Endocrinology, Nutrition and Metabolism, to deepen their knowledge and disseminate it. It is recognized as a Scientific Society of reference in these thematic areas. Each year it chooses an article from among all those published in its journal.