Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P.R. China; Department of Endocrinology, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang, P.R. China.
Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, P.R. China.
Arch Med Res. 2018 Aug;49(6):365-372. doi: 10.1016/j.arcmed.2018.11.003. Epub 2018 Dec 3.
Papillary thyroid cancer (PTC) is the most common epithelial thyroid tumor, accounting for more than 80% of all thyroid cancers. Though the fine needle aspiration biopsy (FNAB) represents as the golden standard for the diagnostics of thyroid nodules, there is a ∼25% risk of indeterminate cytological features. TMPRSS4 is a newly found transmembrane serine protease which was overexpressed in papillary thyroid cancer (PTC).
The aim of this study was to determine its potential as a diagnostic marker to improve the diagnostic accuracy of thyroid cancer.
We used pyrosequencing and quantitative real-time PCR (qRT-PCT) approaches to examine BRAF mutation and TMPRSS4 mRNA level in FNAB specimens of thyroid nodules. The detection and analysis were respectively applied to training group with 91, and test group with 88 samples.
We demonstrated that PTC patients had an increased TMPRSS4 mRNA level as compared with benign subjects. The diagnostic sensitivity, specificity, and accuracy of TMPRSS4 were 93.33, 100, and 96.70%, respectively. Notably, compared with BRAF mutation testing alone, combining with TMPRSS4 mRNA level significantly increased the diagnostic sensitivity and accuracy.
Our findings indicated BRAF mutation combination with TMPRSS4 mRNA analysis can dramatically improve the sensitivity and accuracy of preoperative diagnosis of thyroid nodules.
甲状腺乳头状癌（PTC）是最常见的甲状腺上皮性肿瘤，占所有甲状腺癌的 80%以上。虽然细针穿刺活检（FNAB）是甲状腺结节诊断的金标准，但仍有 25%的不确定细胞学特征风险。TMPRSS4 是一种新发现的跨膜丝氨酸蛋白酶，在甲状腺乳头状癌（PTC）中过表达。
本研究旨在确定其作为诊断标志物的潜力，以提高甲状腺癌的诊断准确性。
我们使用焦磷酸测序和实时定量 PCR（qRT-PCR）方法检测 FNAB 标本中 BRAF 突变和 TMPRSS4 mRNA 水平。分别对 91 例训练组和 88 例测试组进行检测和分析。
与良性组相比，PTC 患者 TMPRSS4 mRNA 水平升高。TMPRSS4 的诊断灵敏度、特异性和准确性分别为 93.33%、100%和 96.70%。值得注意的是，与单独检测 BRAF 突变相比，联合 TMPRSS4 mRNA 水平显著提高了诊断的灵敏度和准确性。
我们的研究结果表明，BRAF 突变联合 TMPRSS4 mRNA 分析可显著提高甲状腺结节术前诊断的灵敏度和准确性。
