应用实时 PCR 定量检测甲状腺刺激激素受体 mRNA 对甲状腺微小乳头状癌的早期诊断价值。

Quantitation of thyroid-stimulating hormone receptor mRNA with real-time PCR for early diagnosis of papillary thyroid microcarcinoma.

机构信息

Department of Surgical Oncology, First People's Hospital of Zhoushan, Zhoushan, Zhejiang Province, China.

出版信息

Neoplasma. 2010;57(4):360-4.

PMID:20429628

Abstract

UNLABELLED

Recently, the value of thyroid-stimulating hormone receptor(TSHR) mRNA as a molecular marker in diagnosis of thyroid cancer has been greatly explored. However, its role in detecting thyroid microcarcinoma has never been reported. In this study, we aim to investigate the value of TSHR mRNA in diagnosis of papillary thyroid microcarcinoma(PTMC). To do that, TSHR mRNA levels were measured by real time PCR in 30 healthy subjects and 72 patients (benign thyroid nodules, n=38; PTMC, n=34). TSHR mRNA levels were then compared with cancer volume in surgical specimen. We found that TSHR mRNA levels in PTMC were significantly higher than benign thyroid nodules(P<0.01). At a cutoff value of 0.71 ng/microg total RNA, the TSHR mRNA correctly classified 77.8% of patients preoperatively (sensitivity= 76.5%; specificity= 79.4%). Comparatively, it performed better in larger PTMC of 0.5-1.0 cm than <0.5 cm(sensitivity, 83.4% vs 72.4%; specificity, 88.5% vs 74.1%). Combining TSHR mRNA and ultra sound examination correctly detect 97.1% of PTMC and could spared surgery in 86.8% of patients with benign thyroid nodules. Thus, TSHR mRNA measured with real time PCR enhances the preoperative detection of PTMC in patients with thyroid nodules, which dramatically reduces unnecessary surgeries.

KEYWORDS

thyroid-stimulating hormone receptor, papillary thyroid microcarcinoma, diagnosis.

摘要

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最近，促甲状腺激素受体（TSHR）mRNA 作为甲状腺癌分子标志物的价值得到了广泛的探索。然而，其在检测甲状腺微小癌中的作用从未有报道。在本研究中，我们旨在研究 TSHR mRNA 在诊断甲状腺微小乳头状癌（PTMC）中的价值。为此，通过实时 PCR 测量了 30 例健康受试者和 72 例患者（良性甲状腺结节，n=38；PTMC，n=34）中 TSHR mRNA 的水平。然后将 TSHR mRNA 水平与手术标本中的癌体积进行比较。我们发现，PTMC 中的 TSHR mRNA 水平明显高于良性甲状腺结节（P<0.01）。在 0.71ng/μg 总 RNA 的截断值下，术前 TSHR mRNA 正确分类了 77.8%的患者（敏感性=76.5%；特异性=79.4%）。相比之下，它在 0.5-1.0cm 的较大 PTMC 中表现优于<0.5cm（敏感性，83.4%对 72.4%；特异性，88.5%对 74.1%）。将 TSHR mRNA 与超声检查相结合，可以正确检测 97.1%的 PTMC，并使 86.8%的良性甲状腺结节患者避免手术。因此，实时 PCR 测量的 TSHR mRNA 增强了甲状腺结节患者中 PTMC 的术前检测，显著减少了不必要的手术。