通过电化学发光免疫分析法检测甲状腺肿瘤细针穿刺冲洗液中的降钙素

Calcitonin measurement in fine-needle aspirate washout fluid by electrochemiluminescence immunoassay for thyroid tumors.

作者信息

Kihara Minoru, Hirokawa Mitsuyoshi, Kudo Takumi, Hayashi Toshitetsu, Yamamoto Masatoshi, Masuoka Hiroo, Higashiyama Takuya, Fukushima Mitsuhiro, Ito Yasuhiro, Miya Akihiro, Miyauchi Akira

机构信息

1Departments of Surgery, Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe, Hyogo 650-0011 Japan.

2Departments of Diagnostic Pathology, Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe, Hyogo 650-0011 Japan.

出版信息

Thyroid Res. 2018 Oct 30;11:15. doi: 10.1186/s13044-018-0059-4. eCollection 2018.

PURPOSE

For the differential diagnosis of medullary thyroid carcinoma (MTC) on thyroid nodules, ultrasound-guided fine-needle aspiration cytology is a useful and safe procedure, but its diagnostic accuracy is not high enough. As an ancillary method to accurately diagnose MTC, the calcitonin in fine-needle aspirate washout fluid (FNA-Ct) is used. However, no data are available about cut-off values of FNA-Ct using the currently available electrochemiluminescence immunoassay (ECLIA).

METHODS

We investigated 180 thyroid nodules in 141 patients. After smearing, the syringe and needle used for the FNA were rinsed with normal saline (0.5 mL). The calcitonin in the washout was measured by ECLIA.

RESULTS

The FNA-Ct in the non-MTC nodules of MTC patients, non-MTC nodules of non-MTC patients, and MTC nodules were 10.6-2100 pg/mL (median 24.6 pg/mL), < 0.5-21.0 pg/mL (median < 0.5 pg/mL), and 94.9-4,070,000 pg/mL (median 177,000 pg/mL), respectively. A receiver operating characteristic analysis of the MTC nodules and the non-MTC nodules of the non-MTC patients indicated that the cut-off value was 21.0 pg/mL, leading to 100% sensitivity and 100% specificity.

CONCLUSIONS

This is the first study to determine the cut-off value of FNA-Ct with an ECLIA, and we propose that the optimal cut-off value is 21.0 pg/mL.

目的

对于甲状腺结节中髓样甲状腺癌（MTC）的鉴别诊断，超声引导下细针穿刺细胞学检查是一种有用且安全的方法，但其诊断准确性不够高。作为准确诊断MTC的辅助方法，使用细针穿刺冲洗液中的降钙素（FNA-Ct）。然而，关于使用目前可用的电化学发光免疫分析（ECLIA）检测FNA-Ct的临界值尚无数据。

方法

我们对141例患者的180个甲状腺结节进行了研究。涂片后，用于细针穿刺的注射器和针头用生理盐水（0.5 mL）冲洗。冲洗液中的降钙素通过ECLIA测量。

结果

MTC患者的非MTC结节、非MTC患者的非MTC结节以及MTC结节中的FNA-Ct分别为10.6 - 2100 pg/mL（中位数24.6 pg/mL）、< 0.5 - 21.0 pg/mL（中位数< 0.5 pg/mL）和94.9 - 4,070,000 pg/mL（中位数177,000 pg/mL）。对非MTC患者的MTC结节和非MTC结节进行的受试者工作特征分析表明，临界值为21.0 pg/mL，灵敏度和特异性均为100%。