Liou Miaw-Jene, Chan Err-Cheng, Lin Jen-Der, Liu Feng-Hsuan, Chao Tzu-Chieh
Section of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital and Chang Gung University, Linkou, Taiwan.
Cancer Lett. 2003 Mar 10;191(2):223-7. doi: 10.1016/s0304-3835(02)00678-x.
Identifying a tumor marker that can help distinguish benign from malignant thyroid tumors is crucial, because up to 30% of thyroid fine-needle aspirations (FNA) are diagnosed as 'suspicious' or follicular neoplasm for malignancy. Recently, the detection of human telomerase reverse transcriptase (hTERT) gene expression in thyroid FNA samples has been identified as a promising diagnostic marker in distinguishing benign and malignant thyroid tumors. Twenty-seven FNA samples from thyroid tumors that were suspected to be malignant were collected preoperatively, hTERT gene expression was examined by reverse transcriptase-polymerase chain reaction (RT-PCR), and the cytological and histological results were compared. The results demonstrated that 13 (92.8%) of 14 thyroid carcinomas, including eight of eight papillary, three of four follicular, and two of two Hürthle cell thyroid carcinomas have corresponding FNA samples that were positive for hTERT. Meanwhile, eight (61.5%) of 13 benign thyroid nodules, including three of six nodular goiter, two of two Graves' disease, two of two Hürthle cell adenomas, and one of three follicular adenomas were positive for hTERT. In conclusion, hTERT was more prevalent in malignant thyroid FNA samples than in the benign thyroid FNA samples. Notably, the extent of the differences in hTERT expression between benign and malignant follicular thyroid tumors require further investigation. Moreover, further information including semi-quantitative real-time RT-PCR, is required to verify whether hTERT mRNA expression could serve as an adjunctive molecular marker for the preoperative diagnosis of thyroid malignancies.
识别一种有助于区分良性和恶性甲状腺肿瘤的肿瘤标志物至关重要，因为高达30%的甲状腺细针穿刺活检（FNA）被诊断为“可疑”或滤泡性肿瘤待查。最近，检测甲状腺FNA样本中的人类端粒酶逆转录酶（hTERT）基因表达已被确定为区分良性和恶性甲状腺肿瘤的一种有前景的诊断标志物。术前收集了27份疑似恶性的甲状腺肿瘤FNA样本，通过逆转录聚合酶链反应（RT-PCR）检测hTERT基因表达，并比较细胞学和组织学结果。结果表明，14例甲状腺癌中的13例（92.8%），包括8例乳头状癌中的8例、4例滤泡状癌中的3例以及2例许特耳细胞甲状腺癌中的2例，其相应的FNA样本hTERT呈阳性。同时，13例良性甲状腺结节中的8例（61.5%），包括6例结节性甲状腺肿中的3例、2例格雷夫斯病中的2例、2例许特耳细胞腺瘤中的2例以及3例滤泡性腺瘤中的1例，hTERT呈阳性。总之，hTERT在恶性甲状腺FNA样本中比在良性甲状腺FNA样本中更普遍。值得注意的是，良性和恶性滤泡性甲状腺肿瘤之间hTERT表达差异的程度需要进一步研究。此外，还需要包括半定量实时RT-PCR在内的更多信息，以验证hTERT mRNA表达是否可作为甲状腺恶性肿瘤术前诊断的辅助分子标志物。
