Differentiating Thyroid Follicular Adenoma from Follicular Carcinoma via G-Protein Coupled Receptor-Associated Sorting Protein 1 (GASP-1)

Sep 24, 2026

Thyroid follicular neoplasms are difficult to classify as benign or malignant when capsular and/or vascular invasion is incomplete or equivocal on histology. This study evaluates G-protein coupled receptor-associated sorting protein 1 (GASP-1) as a potential biomarker for thyroid cancer development and progression. Affinity-purified anti-GASP-1 polyclonal antibodies were applied in routine immunohistochemistry to thyroid tissue microarrays containing normal tissue, follicular adenoma and carcinoma, papillary carcinoma, and anaplastic carcinoma. Results show GASP-1 expression differentiates follicular adenoma from follicular carcinoma, with markedly higher levels in malignant versus normal tissue and in carcinoma versus adenoma.

LanguageEnglish

CategoryHealthcare

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Pages11

Reading Time28 min

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Abstract

Introduction

cancers Article Differentiating Thyroid Follicular Adenoma from Follicular Carcinoma via G-Protein Coupled Receptor-Associated Sorting Protein 1 (GASP-1) Yuan Rong 1, Cesar Torres-Luna 2, George Tuszynski 2, Richard Siderits 3 and Frank N. Chang 2, * Citation: Rong, Y.; Torres-Luna, C.; Tuszynski, G.; Siderits, R.; Chang, F.N. Differentiating Thyroid Follicular Adenoma from Follicular Carcinoma via G-Protein Coupled Receptor-Associated Sorting Protein 1 (GASP-1) . Cancers 2023, 15, 3404 . [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)cancers15133404 Academic Editor: David Wong Received: 17 May 2023 Revised: 9 June 2023 Accepted: 26 June 2023 Published: 29 June 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Department of Pathology and Laboratory Medicine, Temple University School of Medicine, Philadelphia, PA 19140, USA; [yuan.rong@tuhs.temple.edu](yuan.rong@tuhs.temple.edu) 2 Halcyon Diagnostics, 1200 Corporate Blvd. Ste. 10C, Lancaster, PA 17601, USA; [cesar.torres@lynthera.com](cesar.torres@lynthera.com) (C.T.-L.); [george.tuszynski@halcyonrx.com](george.tuszynski@halcyonrx.com) (G.T.) 3 Department of Pathology and Laboratory Medicine, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ 08854, USA; [rick.siderits@dls.com](rick.siderits@dls.com) * Correspondence: [fnchang11@gmail.com](fnchang11@gmail.com); Tel.: +1-(717)-696-8917 Simple Summary: Thyroid nodules are very common as one gets older. Fine-needle aspiration is the primary diagnostic methodology but difﬁculties in the diagnosis of follicular-derived thyroid lesions are well-known. The aim of this study was to assess the potential of G-protein coupled receptorassociated sorting protein 1 (GASP-1) as a valid thyroid cancer biomarker. By using anti-GASP-1 polyclonal antibodies in immunohistochemical (IHC) staining studies, we found that GASP-1 was signiﬁcantly overexpressed in early-stage malignant thyroid neoplasms while it was minimally expressed in normal thyroid cells. We demonstrated that the level of GASP-1 expression can differentiate follicular adenoma from follicular carcinoma. Abstract: Follicular neoplasms are classiﬁed as benign or malignant depending on the presence or absence of capsular and/or vascular invasion. Due to incomplete capsular penetration or equivocal vascular invasion, the evaluation of these features can be challenging using histologic examination. In the current study, we analyzed the involvement of G-protein coupled receptor-associated sorting protein 1 (GASP-1) in the development and progression of thyroid neoplasms. Afﬁnity-puriﬁed anti-GASP-1 polyclonal antibodies were used for routine immunohistochemistry (IHC) analysis. Thyroid tissue microarrays containing normal thyroid tissue, follicular adenoma, follicular carcinoma, papillary thyroid carcinoma, and anaplastic carcinoma were analyzed. We found that the level of GASP-1 expression can differentiate follicular adenoma from follicular carcinoma. When numerous cases were scored for GASP-1 expression by a board-certiﬁed pathologist, we found that GASP-1 expression is 7-fold higher in thyroid malignant neoplasms compared to normal thyroid tissue, and about 4-fold higher in follicular carcinoma compared to follicular adenoma. In follicular adenoma tissues, we observed the presence of many mini-glands that are enriched in GASP-1 and some mini-glands contain as few as three cells. GASP-1 IHC also possesses several advantages over the conventional H&E and can be used to identify early thyroid cancer and monitor cancer progression. Keywords: thyroid cancer biomarker; thyroid nodule; immunoh

FAQs

Why is distinguishing follicular adenoma from follicular carcinoma challenging?

Classification relies on detecting capsular and/or vascular invasion, but incomplete capsular penetration or equivocal vascular invasion makes histologic evaluation difficult.

How was GASP-1 evaluated in the study?

The study used affinity-purified anti-GASP-1 polyclonal antibodies for routine immunohistochemistry on thyroid tissue microarrays.

What diagnostic performance signal did the researchers find for GASP-1?

GASP-1 expression was significantly higher in early-stage malignant thyroid neoplasms than in normal thyroid cells and differentiated follicular adenoma from follicular carcinoma.

Sep 24, 2026

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