Azoury Saïd C, Aufforth Rachel, He Mei, Yang Zhiming, Nilubol Naris, Kebebew Electron
Surgery Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
Department of Surgery, Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, Maryland.
Head Neck. 2015 Nov;37(11):E165-8. doi: 10.1002/hed.24054. Epub 2015 Jul 14.
Despite improved surveillance for patients after total thyroidectomy for cancer, there has yet to be a diagnostic method that detects recurrence with 100% accuracy.
A 60-year-old woman with a family history of papillary thyroid cancer (PTC) underwent total thyroidectomy and radioactive iodine ablation. On postoperative surveillance, ultrasound examination of the neck demonstrated a focus concerning for recurrence and a fine-needle aspirate (FNA) was performed. The cytology report was nondiagnostic and, hence, RNA was extracted from the specimen followed by reverse transcription (cDNA), and quantitative real-time polymerase chain reaction (qRT-PCR) to detect thyroid-specific gene expression (thyroglobulin =Tg; sodium-iodide symporter = NIS; thyroperoxidase = TPO).
Expression of select thyroid-specific genes was demonstrated, and given the patient's remarkable cancer and family history, surgical resection was elected. Final pathology demonstrated follicular adenoma.
This case demonstrates a novel approach used in the evaluation for recurrent thyroid cancer as an adjunct to FNA cytology.
尽管对甲状腺癌全切除术后患者的监测有所改善，但尚未有一种诊断方法能100%准确检测复发情况。
一名有甲状腺乳头状癌（PTC）家族史的60岁女性接受了甲状腺全切除术及放射性碘消融治疗。术后监测时，颈部超声检查发现一个可疑复发灶，遂进行细针穿刺抽吸活检（FNA）。细胞学报告无法确诊，因此从标本中提取RNA，随后进行逆转录（cDNA）以及定量实时聚合酶链反应（qRT-PCR），以检测甲状腺特异性基因表达（甲状腺球蛋白=Tg；钠碘同向转运体=NIS；甲状腺过氧化物酶=TPO）。
证实了所选甲状腺特异性基因的表达，鉴于该患者显著的癌症及家族病史，决定进行手术切除。最终病理显示为滤泡性腺瘤。
本病例展示了一种用于评估复发性甲状腺癌的新方法，作为FNA细胞学检查的辅助手段。
