Pomorski L, Kaczka Krzysztof, Piaskowski S, Wójcik I, Rieske P, Matejkowska M, Kuzdak K
Department of Endocrinological and General Surgery, Medical University of Lodz, Pabianicka 62, 93-513, Lodz, Poland.
Langenbecks Arch Surg. 2005 Jun;390(3):209-15. doi: 10.1007/s00423-004-0528-1. Epub 2005 Jan 8.
The range of lymphadenectomy in differentiated thyroid cancer remains still a matter of controversy because of the lack of reliable diagnostic methods for nodal metastases, other than histopathology.
To compare the results of detection of lymph node metastases of papillary thyroid cancer by conventional histopathology and immunohistochemistry with the results of reverse transcription-polymerase chain reaction for thyroglobulin mRNA.
Each of 166 cervical lymph nodes obtained from 21 patients was divided into two halves: one was used for conventional histopathology and immunohistochemistry, the other part was investigated by molecular examination.
We obtained different results from examination of the lymph nodes in six (28.6%) patients. In four patients (19.1%) reverse transcription-polymerase chain reaction (RT-PCR) was more sensitive in detection of positive lymph nodes; in two patients (9.5%) it revealed fewer metastasised lymph nodes than did histopathology. The rest of the patients did not have any differences: 12 (57.1%) of them had negative lymph nodes and three (14.3%) had positive lymph nodes in all examinations.
(1) Thyroglobulin (Tg) RT-PCR is an appropriate method of detection for thyroid cancer cells. (2) In combination with histopathology, it might help to qualify patients' nodal status better.
除组织病理学外，由于缺乏可靠的淋巴结转移诊断方法，分化型甲状腺癌的淋巴结清扫范围仍存在争议。
比较甲状腺乳头状癌淋巴结转移的传统组织病理学和免疫组化检测结果与甲状腺球蛋白mRNA逆转录-聚合酶链反应的结果。
从21例患者获取的166个颈部淋巴结均分成两半：一半用于传统组织病理学和免疫组化，另一半进行分子检测。
我们在6例（28.6%）患者的淋巴结检查中得到了不同结果。4例患者（19.1%）中，逆转录-聚合酶链反应（RT-PCR）检测阳性淋巴结更敏感；2例患者（9.5%）中，RT-PCR显示转移淋巴结比组织病理学检查少。其余患者无差异：所有检查中，12例（57.1%）患者淋巴结阴性，3例（14.3%）患者淋巴结阳性。
（1）甲状腺球蛋白（Tg）RT-PCR是检测甲状腺癌细胞的合适方法。（2）与组织病理学相结合，它可能有助于更好地明确患者的淋巴结状态。
