Genetic Bases of Thyroid Tumor Laboratory, Division of Genetics, Department of Morphology and Genetics, Federal University of São Paulo, SP, Brazil.
Mol Cell Endocrinol. 2010 May 28;321(1):77-85. doi: 10.1016/j.mce.2009.11.008. Epub 2009 Nov 20.
Thyroid nodules are commonly encountered during routine medical care. The main problem established by a discovery of a thyroid nodule is to discriminate between a benign and malignant lesion. Fine-needle aspiration (FNA) is the most widely used and cost-effective preoperative test for initial evaluation of a thyroid nodule. While the overall accuracy of FNA for classical papillary thyroid carcinoma (PTC) approaches 100%, it has limited accuracy with follicular lesions. Patients with a cytological report of indeterminate or follicular lesions are referred to surgery for a more accurate diagnosis. A more acute molecular-based test for thyroid nodules is needed not only to improve treatment decisions, but also to potentially reduce the long-term health costs. Several studies have looked into biologic markers that could be used as an adjuvant to distinguish the benign from malignant nodules. This review will focus on those biomarkers that are potentially useful in the diagnosis of thyroid lesions commonly classified as indeterminate.
甲状腺结节在常规医疗中很常见。发现甲状腺结节后，主要的问题是区分良性和恶性病变。细针抽吸（FNA）是用于甲状腺结节初步评估的最广泛使用且具有成本效益的术前检查。虽然 FNA 对经典甲状腺乳头状癌（PTC）的总体准确率接近 100%，但对于滤泡性病变的准确率有限。细胞学报告为不确定或滤泡性病变的患者需要手术以获得更准确的诊断。不仅需要更灵敏的基于分子的甲状腺结节检测方法来改善治疗决策，还有可能降低长期的健康成本。已有多项研究探讨了可作为辅助手段来区分良性和恶性结节的生物标志物。本文将重点介绍那些对通常归类为不确定的甲状腺病变的诊断有潜在应用价值的生物标志物。
