Department of Internal Medicine, Neurology and Dermatology, Clinic for Endocrinology and Nephrology, University of Leipzig, Liebigstr. 18, 04103 Leipzig, Germany.
Br J Cancer. 2012 Jan 31;106(3):562-8. doi: 10.1038/bjc.2011.578. Epub 2012 Jan 5.
Previously, we reported a six-marker gene set, which allowed a molecular discrimination of benign and malignant thyroid tumours. Now, we evaluated these markers in fine-needle aspiration biopsies (FNAB) in a prospective, independent series of thyroid tumours with proven histological outcome.
Quantitative RT-PCR was performed (ADM3, HGD1, LGALS3, PLAB, TFF3, TG) in the needle wash-out of 156 FNAB of follicular adenoma (FA), adenomatous nodules, follicular and papillary thyroid cancers (TC) and normal thyroid tissues (NT).
Significant expression differences were found for TFF3, HGD1, ADM3 and LGALS3 in FNAB of TC compared with benign thyroid nodules and NT. Using two-marker gene sets, a specific FNAB distinction of benign and malignant tumours was achieved with negative predictive values (NPV) up to 0.78 and positive predictive values (PPV) up to 0.84. Two FNAB marker gene combinations (ADM3/TFF3; ADM3/ACTB) allowed the distinction of FA and malignant follicular neoplasia with NPV up to 0.94 and PPV up to 0.86.
We demonstrate that molecular FNAB diagnosis of benign and malignant thyroid tumours including follicular neoplasia is possible with recently identified marker gene combinations. We propose multi-centre FNAB studies on these markers to bring this promising diagnostic tool closer to clinical practice.
此前,我们报道了一个由六个基因组成的基因集,可用于区分良性和恶性甲状腺肿瘤。现在,我们在一系列经组织学证实的前瞻性、独立甲状腺肿瘤细针抽吸活检(FNAB)中评估了这些标志物。
对 156 例滤泡性腺瘤(FA)、腺瘤性结节、滤泡性和乳头状甲状腺癌(TC)和正常甲状腺组织(NT)的FNAB 冲洗液进行了定量 RT-PCR(ADM3、HGD1、LGALS3、PLAB、TFF3、TG)。
TC 的 FNAB 中 TFF3、HGD1、ADM3 和 LGALS3 的表达差异有统计学意义,与良性甲状腺结节和 NT 相比。使用两标志物基因集,可实现良性和恶性肿瘤的特异性 FNAB 区分,阴性预测值(NPV)高达 0.78,阳性预测值(PPV)高达 0.84。两种 FNAB 标记基因组合(ADM3/TFF3;ADM3/ACTB)可将 FA 和恶性滤泡性肿瘤区分开来,NPV 高达 0.94,PPV 高达 0.86。
我们证明了使用最近确定的标记基因组合对良性和恶性甲状腺肿瘤(包括滤泡性肿瘤)进行分子 FNAB 诊断是可行的。我们建议对这些标志物进行多中心 FNAB 研究,以使这一有前途的诊断工具更接近临床实践。