Thyroid CancerNCT05463107
Correlation Between Various Urinary Exosomal Protein Biomarkers and Pathological Manifestation in Thyroid Follicular Neoplasm: Early and Pre-operative Diagnosis of Follicular Thyroid Cancer
An observational study of Thyroid Cancer and Follicular Thyroid Cancer, run by National Taiwan University Hospital at 1 site in Taiwan.
Trial summary
Thyroid cancer is the most common endocrine malignancy in the world. Generally, thyroid cancer could be divided into well-differentiated and poorly-differentiated. Well-differentiated thyroid cancers usually have two different patterns, including papillary thyroid cancer and follicular thyroid cancer. Read more about this study
- Who is it for?
- Ages 20 to 80 years
- Conditions the study is for
- Thyroid Cancer, Follicular Thyroid Cancer
- How many people
- 50 participants
- Where
- 1 siteTaiwan
- Study dates
- 1 Aug 2022to 31 Jul 2028
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 20 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Clinical study was designed as prospective pattern, and enrolled patients with nodular goiter or multinodular goiter, who had received fine needle aspiration cytology and/or thyroidectomy. Cytology and complete surgical pathology survey will be recorded for cytological and surgical samples. This study will enroll 50 consecutive patients with nodular goiter or multinodular goiter in 2nd and 3rd years.
Who may be able to join
- diagnosed patients with nodular goiter or multinodular goiter, thyroid papillary, follicular and anaplastic thyroid cancer, pre-operation.
Who cannot join
- unclearly diagnosed patients with thyroid papillary, follicular and anaplastic thyroid cancer
Trial locations and contacts
1 site in 1 country.
About this study
Thyroid cancer is the most common endocrine malignancy in the world. Generally, thyroid cancer could be divided into well-differentiated and poorly-differentiated. Well-differentiated thyroid cancers usually have two different patterns, including papillary thyroid cancer and follicular thyroid cancer. Thyroid sonography is convenient to obtain repeatedly for the images of nodular goiter. However, cytology and pathology are still the golden rules to make the final diagnosis. Under the basis of sono-guided fine needle aspiration cytology, diagnosis of papillary thyroid cancer is typically using fine needle aspiration cytology based on the presentation of typical cytologic features. On the other hand, thyroid follicular lesion cannot be interpretated via cytology because the evidence of capsular invasion or vascular permeation of capsule will not be available in fine needle aspiration cytology. Surgical intervention with pathological specimens is the only pathway to make the final diagnosis. Interestingly, both patterns of well-differentiated thyroid cancer shared the same follow-up tumor marker, i.e. serum thyroglobulin. Up to date, pre-operative diagnosis of follicular thyroid cancer is still one of the unresolved issues in endocrine oncology.
Read the detailed description
Thyroid cancer is one of the most popular malignancy in the past several decades all over the world. For poorly-differentiated thyroid cancer, therapeutic strategy of costly target therapy together with immune therapy will be the pivotal one because of its poor prognosis. The average 5-year relative survival rate of anaplastic thyroid cancer is only 3 to 31 % on the stage from distant metastasis to localized disease.
However, it will be very different for well-differentiated thyroid cancer, and the average 5-year relative survival rate of both thyroid papillary or follicular thyroid cancer is more than 98 %. Therefore, the most important treatment strategy for endocrinologists will consider the development of biomarkers for early diagnosis and postoperative follow-up, rather than measuring serum thyroglobulin alone, which is the only biomarker in the current medical guidelines, and there is no choice. Our research team tried to find the newer biomarker together with serum thyroglobulin for post-operative longitudinal follow-up of well-differentiated thyroid cancer in the past five years. The investigators used urinary exosomal proteins as target and did find several peptides to be helpful, including our published urinary exosomal thyroglobulin (UExTg). In Taiwan, goiter and thyroid cancer are prevalent diseases. Although papillary thyroid cancer could be diagnosed via reliable sono-guided fine needle aspiration cytology, follicular thyroid cancer is still an unresolved issue in daily medical practice, especially in cytology. the investigators need to find a practicably earlier biomarker, which should be convenient, non-invasive and repeatable in sample collection. In our previous research and published data, urine will be a reliable source of data.
Exosomes are nano-vesicles, containing DNA, RNA and proteins, and usually secreted by cells into extracellular spaces. Generally, the vesicles of exosomes are only 40 to 150 nm in diameter. Exosomes may carry and transfer the messages between different tissues. Now, the existing evidences revealed that exosomes may represent certain messages from malignant cells, including diagnosed biomarkers or prognostic predictors. Previously, published data of exosomal studies in thyroid cancer focused on serum microRNA, long coding RNA and circular RNA, but only few published data on peptides, which were named as liquid biopsy. However, cell-secreted exosomes of malignancy could be collected not only in plasma, body fluid, but also from urine, which is the non-invasive pathway but valuable wastes of human body. Our research group had developed experienced technique to collect urinary exosomes via our pilot study in the past several years.
Since the investigators proved the role of urinary exosomal thyroglobulin, UExTg, in post-operative follow-up in well-differentiated thyroid cancer in the past three years, from 2018-2020, the investigators also found several peptides to be the candidates of prognostic predictors in our preliminary studies, including Calprotectin A8/A9, Annexin-2, Angiopoietin-1.
- Conditions
- Thyroid Cancer, Follicular Thyroid Cancer
- Keywords
- Exosome, Urine, Biological marker, Thyroglobulin, Galactin-3
- Medical subject headings
- Thyroid Neoplasms, Adenocarcinoma, Follicular
What is being measured
The primary outcome is the main question the study is designed to answer.
Change of serum thyroglobulin level
Thyroid function test
Measured: Within 36 months
Change of serum free T4 level
Thyroid function test
Measured: Within 36 months
Change of serum TSH level
Thyroid function test
Measured: Within 36 months
Change of anti-thyroglobulin level
Thyroid function test
Measured: Within 36 months
Urinary exosomal thyroglobulin detection
Urinary exosomal biomarker
Measured: Within 36 months
Urinary exosomal galectin-3 detection
Urinary exosomal biomarker
Measured: Within 36 months
Urinary exosomal calprotectin A9 detection
Urinary exosomal biomarker
Measured: Within 36 months
Urinary exosomal transketolase detection
Urinary exosomal biomarker
Measured: Within 36 months
Urinary exosomal keratin 19 detection
Urinary exosomal biomarker
Measured: Within 36 months
Urinary exosomal angiopoietin-1 detection
Urinary exosomal biomarker
Measured: Within 36 months
Urinary exosomal tissue inhibitor of metalloproteinase detection
Urinary exosomal biomarker
Measured: Within 36 months
Urinary exosomal keratin 8 detection
Urinary exosomal biomarker
Measured: Within 36 months
Urinary exosomal calprotectin A8 detection
Urinary exosomal biomarker
Measured: Within 36 months
Urinary exosomal annexin II detection
Urinary exosomal biomarker
Measured: Within 36 months
Urinary exosomal afamin detection
Urinary exosomal biomarker
Measured: Within 36 months
Secondary outcomes (2)
Thyroid fine needle aspiration cytology
Urinary exosomal biomarker
Measured: Within 36 months
Ultrasonography of thyroid nodules
Urinary exosomal biomarker
Measured: Within 36 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Jul 2022
- Study start1 Aug 2022
- Primary completion8 Apr 2026 (estimated)
- Study completion31 Jul 2028 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Thyroid CancerStudies of the same condition, open and under way.
- More trials run by National Taiwan University HospitalThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 50 participants (estimated)
Sponsor and investigators
- Lead sponsor
- National Taiwan University Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- CHIH-YUAN WANG, Doctor, Principal investigator, Department of Internal Medicine, National Taiwan University Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05463107
- Sponsor's protocol ID
- 202110076RINB
- Status last verified
- Jun 2025
- First submitted
- 14 Jul 2022
- Last updated
- 13 Apr 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 13 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Correlation Between Various Urinary Exosomal Protein Biomarkers and Pathological Manifestation in Thyroid Follicular Neoplasm: Early and Pre-operative Diagnosis of Follicular Thyroid Cancer
- ClinicalTrials.gov ID
- NCT05463107
- Acronym / sponsor ID
- 202110076RINB
- Conditions
- Thyroid Cancer, Follicular Thyroid Cancer
- Keywords
- Exosome, Urine, Biological marker, Thyroglobulin, Galactin-3
- Study type
- Observational
- Recruitment status
- Active, not recruiting
- Enrolment
- 50 participants (estimated)
- Lead sponsor
- National Taiwan University HospitalUniversity, hospital or other
- Study start
- 1 Aug 2022 (actual)
- Primary completion
- 8 Apr 2026 (estimated)
- Study completion
- 31 Jul 2028 (estimated)
- First posted
- 18 Jul 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Thyroid cancer is the most common endocrine malignancy in the world. Generally, thyroid cancer could be divided into well-differentiated and poorly-differentiated. Well-differentiated thyroid cancers usually have two different patterns, including papillary thyroid cancer and follicular thyroid cancer. Thyroid sonography is convenient to obtain repeatedly for the images of nodular goiter. However, cytology and pathology are still the golden rules to make the final diagnosis. Under the basis of sono-guided fine needle aspiration cytology, diagnosis of papillary thyroid cancer is typically using fine needle aspiration cytology based on the presentation of typical cytologic features. On the other hand, thyroid follicular lesion cannot be interpretated via cytology because the evidence of capsular invasion or vascular permeation of capsule will not be available in fine needle aspiration cytology. Surgical intervention with pathological specimens is the only pathway to make the final diagnosis. Interestingly, both patterns of well-differentiated thyroid cancer shared the same follow-up tumor marker, i.e. serum thyroglobulin. Up to date, pre-operative diagnosis of follicular thyroid cancer is still one of the unresolved issues in endocrine oncology.
Detailed description
Thyroid cancer is one of the most popular malignancy in the past several decades all over the world. For poorly-differentiated thyroid cancer, therapeutic strategy of costly target therapy together with immune therapy will be the pivotal one because of its poor prognosis. The average 5-year relative survival rate of anaplastic thyroid cancer is only 3 to 31 % on the stage from distant metastasis to localized disease.
However, it will be very different for well-differentiated thyroid cancer, and the average 5-year relative survival rate of both thyroid papillary or follicular thyroid cancer is more than 98 %. Therefore, the most important treatment strategy for endocrinologists will consider the development of biomarkers for early diagnosis and postoperative follow-up, rather than measuring serum thyroglobulin alone, which is the only biomarker in the current medical guidelines, and there is no choice. Our research team tried to find the newer biomarker together with serum thyroglobulin for post-operative longitudinal follow-up of well-differentiated thyroid cancer in the past five years. The investigators used urinary exosomal proteins as target and did find several peptides to be helpful, including our published urinary exosomal thyroglobulin (UExTg). In Taiwan, goiter and thyroid cancer are prevalent diseases. Although papillary thyroid cancer could be diagnosed via reliable sono-guided fine needle aspiration cytology, follicular thyroid cancer is still an unresolved issue in daily medical practice, especially in cytology. the investigators need to find a practicably earlier biomarker, which should be convenient, non-invasive and repeatable in sample collection. In our previous research and published data, urine will be a reliable source of data.
Exosomes are nano-vesicles, containing DNA, RNA and proteins, and usually secreted by cells into extracellular spaces. Generally, the vesicles of exosomes are only 40 to 150 nm in diameter. Exosomes may carry and transfer the messages between different tissues. Now, the existing evidences revealed that exosomes may represent certain messages from malignant cells, including diagnosed biomarkers or prognostic predictors. Previously, published data of exosomal studies in thyroid cancer focused on serum microRNA, long coding RNA and circular RNA, but only few published data on peptides, which were named as liquid biopsy. However, cell-secreted exosomes of malignancy could be collected not only in plasma, body fluid, but also from urine, which is the non-invasive pathway but valuable wastes of human body. Our research group had developed experienced technique to collect urinary exosomes via our pilot study in the past several years.
Since the investigators proved the role of urinary exosomal thyroglobulin, UExTg, in post-operative follow-up in well-differentiated thyroid cancer in the past three years, from 2018-2020, the investigators also found several peptides to be the candidates of prognostic predictors in our preliminary studies, including Calprotectin A8/A9, Annexin-2, Angiopoietin-1.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- 20 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Clinical study was designed as prospective pattern, and enrolled patients with nodular goiter or multinodular goiter, who had received fine needle aspiration cytology and/or thyroidectomy. Cytology and complete surgical pathology survey will be recorded for cytological and surgical samples. This study will enroll 50 consecutive patients with nodular goiter or multinodular goiter in 2nd and 3rd years.
Key inclusion criteria (1 listed)
- diagnosed patients with nodular goiter or multinodular goiter, thyroid papillary, follicular and anaplastic thyroid cancer, pre-operation.
Key exclusion criteria (1 listed)
- unclearly diagnosed patients with thyroid papillary, follicular and anaplastic thyroid cancer
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Change of serum thyroglobulin level
Time frame: Within 36 months
Thyroid function test
Change of serum free T4 level
Time frame: Within 36 months
Thyroid function test
Change of serum TSH level
Time frame: Within 36 months
Thyroid function test
Change of anti-thyroglobulin level
Time frame: Within 36 months
Thyroid function test
Urinary exosomal thyroglobulin detection
Time frame: Within 36 months
Urinary exosomal biomarker
Urinary exosomal galectin-3 detection
Time frame: Within 36 months
Urinary exosomal biomarker
Urinary exosomal calprotectin A9 detection
Time frame: Within 36 months
Urinary exosomal biomarker
Urinary exosomal transketolase detection
Time frame: Within 36 months
Urinary exosomal biomarker
Urinary exosomal keratin 19 detection
Time frame: Within 36 months
Urinary exosomal biomarker
Urinary exosomal angiopoietin-1 detection
Time frame: Within 36 months
Urinary exosomal biomarker
Urinary exosomal tissue inhibitor of metalloproteinase detection
Time frame: Within 36 months
Urinary exosomal biomarker
Urinary exosomal keratin 8 detection
Time frame: Within 36 months
Urinary exosomal biomarker
Urinary exosomal calprotectin A8 detection
Time frame: Within 36 months
Urinary exosomal biomarker
Urinary exosomal annexin II detection
Time frame: Within 36 months
Urinary exosomal biomarker
Urinary exosomal afamin detection
Time frame: Within 36 months
Urinary exosomal biomarker
2 secondary outcomes
Thyroid fine needle aspiration cytology
Time frame: Within 36 months
Ultrasonography of thyroid nodules
Time frame: Within 36 months
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Apr 2026.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
CHIH-YUAN WANG, Doctor principal investigator
Department of Internal Medicine, National Taiwan University Hospital
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Thyroid Cancer and Follicular Thyroid Cancer, run by National Taiwan University Hospital at 1 site in Taiwan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 13 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Taiwan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change of serum thyroglobulin level (time frame: Within 36 months). The study lists 15 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Apr 2026.