Abstract

Hurthle cell carcinoma (HCC) is an aggressive form of thyroid cancer. While mitochondrial DNA mutations and chromosomal losses have been identified in HCC, isoform switching, and its functional consequences remain uncharacterized. This study reanalyzed NCBI GEO dataset GSE228870 (n = 32), using Salmon and IsoformSwitchAnalyzeR() to identify isoform switching. The analysis resulted in 371 switches across 335 genes showing functional consequences including loss of protein domains, shorter open reading frames (ORFs), loss of signal peptides and novel sub-cellular localizations. Most significant isoform switches (q-value < 0.05, |dIF| > 0.1) were observed in LAMA2, LSP1, MAD2L2, FBLN2 and CXCL12, implicating extracellular matrix dysregulation, DNA damage response, immune signaling and cytoskeleton regulation. These genes are expressed in normal thyroid (median TPM 20.69, 11.66, 14.79, 134.1 & 80.76). However, specific isoforms of LAMA2 and MAD2L2 are not expressed in normal thyroid, explaining tumor-specific expression in HCC. Alternative transcription termination site (ATTS) gain was significant, suggesting altered 3' end in HCC transcripts. TCGA SpliceSeq showed LSP1, FBLN2 and CXCL12 undergo alternative promoter (LSP1 exon1 PSI=94.5%, FBLN2 exon2 PSI=99.0%) and alternative termination (CXCL12 exon3.3 PSI=53.9%) in thyroid cancer, suggesting ATTS and alternative transcription start site (ATSS) as shared splicing dysregulation mechanisms. This is the first systematic characterization of isoform-level dysregulation in HCC.