Woliński Kosma, Stangierski Adam, Szczepanek-Parulska Ewelina, Gurgul Edyta, Wrotkowska Elżbieta, Biczysko Maciej, Ruchała Marek
Department of Endocrinology, Metabolism and Internal Medicine Poznan University of Medical Sciences.
Endokrynol Pol. 2016;67(6):550-553. doi: 10.5603/EP.2016.0067.
In the evaluation of molecular markers in washouts from fine-needle aspiration biopsy (FNAB) the extremely small amount of material can be a major problem. Some authors tried to use washouts from core-needle aspiration biopsy (CNABs) to gain more material from larger needles. However, according to some studies, CNAB samples are commonly contaminated with blood. The aim of our study was to evaluate the proportion of nucleic acids from thyroid cells in washouts from FNAB and CNAB by measuring the relative expression of cytokeratin 17 (KRT17) on the mRNA level.
Relative expression of KRT17 and GADPH (reference gene) in washouts from FNAB and CNAB was measured using real-time PCR technique and compared to the results from surgical specimens.
Surgical specimens form 22 nodules, FNAB samples from 20 lesions and CNAB samples from 24 lesions were analysed. The median difference in cycle threshold (Ct) between FNAB samples and surgical specimens was 3.3 (p = 0.047). In CNAB samples KRT17 was undetectable in most cases (median incalculable; proportion of samples with undetectable KRT17 significantly higher than in FNAB samples).
Samples obtained with different biopsy techniques had different proportions of contents. The proportionally low content of epithelial cells in CNAB can result in underestimated expression of molecular markers of malignancy. Consequently, the risk of malignancy or unfavourable prognosis can also be underestimated. To conclude, results obtained from samples gained with one biopsy technique cannot be directly related to thresholds, and generally with experiences gained with other techniques, because it can lead to incorrect clinical interpretation of the results. (Endokrynol Pol 2016; 67 (6): 550-553).
在评估细针穿刺活检(FNAB)冲洗液中的分子标志物时,极少的样本量可能是一个主要问题。一些作者尝试使用粗针穿刺活检(CNAB)的冲洗液,以便从更大的针中获取更多样本。然而,根据一些研究,CNAB样本通常会被血液污染。我们研究的目的是通过测量细胞角蛋白17(KRT17)在mRNA水平上的相对表达,评估FNAB和CNAB冲洗液中甲状腺细胞核酸的比例。
使用实时PCR技术测量FNAB和CNAB冲洗液中KRT17和GADPH(参照基因)的相对表达,并与手术标本的结果进行比较。
分析了22个结节的手术标本、20个病变的FNAB样本和24个病变的CNAB样本。FNAB样本与手术标本之间的循环阈值(Ct)中位数差异为3.3(p = 0.047)。在CNAB样本中,大多数情况下无法检测到KRT17(中位数无法计算;KRT17检测不到的样本比例显著高于FNAB样本)。
不同活检技术获取的样本所含成分比例不同。CNAB中上皮细胞比例相对较低可能导致恶性分子标志物的表达被低估。因此,恶性风险或不良预后也可能被低估。总之,用一种活检技术获得的样本结果不能直接与阈值相关联,一般也不能与其他技术的经验相关联,因为这可能导致对结果的临床解读错误。(《Endokrynol Pol》2016年;67(6):550 - 553)