3rd Medical Department, University of Leipzig, Ph.-Rosenthal-Str. 27, D-04103 Leipzig, Germany.
Mol Cell Endocrinol. 2010 Jun 30;322(1-2):29-37. doi: 10.1016/j.mce.2010.01.010. Epub 2010 Jan 18.
Fine-needle aspiration biopsy (FNAB) is currently the most sensitive and specific tool for the presurgical differential diagnosis of thyroid malignancy, but has also substantial limitations. While approximately 75% of FNAB reveal benign lesions and 5% already cytologically prove malignancy, up to 20% of FNAB show follicular proliferation for which follicular adenoma, follicular carcinoma, and follicular variant of papillary carcinoma can only be distinguished histologically, thus requiring thyroid surgery. However, new biomarkers that might improve the accuracy of FNAB come along with the discovery of more and more details of the molecular etiology of thyroid tumors. So far molecular testing for somatic mutations is most promising (e.g., BRAF), since the proposed biomarkers from mRNA- and miRNA-expression studies need further evaluation, especially in FNAB samples. Nevertheless, the application of molecular markers will significantly improve thyroid tumor diagnosis and thus it will help to prevent unnecessary surgeries and it will also help to guide mutation-specific targeted therapies.
细针穿刺活检（FNAB）是目前术前鉴别甲状腺恶性肿瘤最敏感、最特异的工具，但也有很大的局限性。FNAB 约有 75%显示良性病变，5%细胞学已证实为恶性，但高达 20%的 FNAB 显示滤泡增生，其中滤泡性腺瘤、滤泡状癌和甲状腺乳头状癌滤泡型仅能通过组织学鉴别，因此需要甲状腺手术。然而，随着对甲状腺肿瘤分子病因的更多了解，新的生物标志物可能会提高 FNAB 的准确性。到目前为止，体细胞突变的分子检测最有前途（例如 BRAF），因为来自 mRNA 和 miRNA 表达研究的提出的生物标志物需要进一步评估，特别是在 FNAB 样本中。然而，分子标志物的应用将显著改善甲状腺肿瘤的诊断，从而有助于预防不必要的手术，并有助于指导突变特异性靶向治疗。
