Torregrossa Liborio, Shintu Laetitia, Nambiath Chandran Jima, Tintaru Aura, Ugolini Clara, Magalhães Alviclér, Basolo Fulvio, Miccoli Paolo, Caldarelli Stefano
Department of Surgery, University of Pisa , 56100 Pisa, Italy.
J Proteome Res. 2012 Jun 1;11(6):3317-25. doi: 10.1021/pr300105e. Epub 2012 May 4.
Cytological analysis of thyroid nodules detected using ultrasound-guided fine-needle aspiration technique is an efficient method for the diagnosis of well-differenciated tumors such as papillary thyroid carcinoma. However, for between 10 to 30% of all the nodules, the cytological analysis based on fine-needle aspiration biopsies leads to an "indeterminated" identification. Consequently, a surgical excision is then necessary for a definite histological diagnosis of the lesions, resulting in 85% of the patient with indeterminated nodules undergoing unnecessary surgery since their tumor is finally diagnosed as benign. In this work, we discuss how HRMAS (1)H NMR-based metabolomics could be a complementary tool for the diagnosis of these elusive cases. We first showed that our approach was able to discriminate clearly any types of thyroid lesions from healthy tissues. Then we proceeded to demonstrate that the information produced by (1)H HRMAS NMR spectra differentiate tumors according to their malignancy grade, even when they belong to the "indeterminate" category. Analysis of the discriminating spectral area in this last case points out toward a possible increase of phenylalanine, taurine, and lactate and a decrease of choline and choline derivatives, myo- and scyllo-inositol in the malignant tumors compared to the benign ones.
使用超声引导下细针穿刺技术检测甲状腺结节的细胞学分析是诊断如甲状腺乳头状癌等高分化肿瘤的有效方法。然而，在所有结节中，有10%至30%的结节基于细针穿刺活检的细胞学分析会得出“不确定”的结果。因此，为了对病变进行明确的组织学诊断，需要进行手术切除，这导致85%的不确定结节患者接受了不必要的手术，因为他们的肿瘤最终被诊断为良性。在这项工作中，我们讨论了基于高分辨魔角旋转氢核磁共振波谱（HRMAS 1H NMR）的代谢组学如何能够成为诊断这些疑难病例的补充工具。我们首先表明，我们的方法能够清晰地区分任何类型的甲状腺病变与健康组织。然后我们进一步证明，即使肿瘤属于“不确定”类别，1H HRMAS NMR谱产生的信息也能根据肿瘤的恶性程度对其进行区分。对最后这种情况下的鉴别谱区分析指出，与良性肿瘤相比，恶性肿瘤中苯丙氨酸、牛磺酸和乳酸可能增加，胆碱及其衍生物、肌醇和鲨肌醇减少。
