Mahmood Noah Abd-Alkader, Tawfeeq Amer Talib, Al-Sudani Israa Mhdi, Abd-Alghni Zaynab Saad
Molecular Biology Lab, Department of Molecular Biology, Iraqi Center for Cancer and Medical Genetics Research, Mustansiriyah University, Baghdad, Iraq.
College of Medicine, Ibn Sina University of Medical and Pharmaceutical Sciences, Baghdad, Iraq.
J Oncol. 2019 Jun 24;2019:1659654. doi: 10.1155/2019/1659654. eCollection 2019.
Fine needle aspiration biopsy (FNAB) is a standard procedure for the detection of thyroid nodules malignancy, yet 10-25% of the sample diagnosed may go undetermined or suspicious. The utility of cancer stem cell markers (CSCM) as a differential diagnosis molecular marker in nodules of suspicious decision in FNAB was hypothesized. Papillary thyroid carcinoma (PTC) and thyroid fibroadenoma (TFA) samples were selected to test the hypothesis. The samples employed in this study were from patients who had thyroid hyperplasia and a suspicious or undetermined diagnosis by FNAB. The patient underwent a successful thyroidectomy at Al-Yarmouk Teaching Hospital in Baghdad between January 2015 and December 2017. All nodule samples underwent a systematic histopathological examination after resection. Tumors diagnosed as PTC and those diagnosed as fibroadenoma (TFA) were selected for this study. Collectively 39 PTC and 11 TFA nodules were included. Quantitative reverse transcriptase real-time PCR (qRT-PCR) and immunohistochemistry (IHC) were used to determine levels of mRNA and proteins of CSCM ALDH1A1, CD44, ABCG2, and Oct3/4 in both types of tumors were used. This study revealed that the expression levels of CSCM were significantly increased in PTC tissues when compared to benign tissues and the positive correlation was found between the CSCM expression levels and tumor stage, size, and gender. In conclusion, for a more precise diagnosis, we suggest these markers be included in what is currently available to characterize malignancy from what is not in thyroid cancer, as well as for the staging process of PTC.
细针穿刺活检（FNAB）是检测甲状腺结节恶性肿瘤的标准程序，但10%-25%被诊断的样本可能无法确定或存在可疑情况。本研究假设癌症干细胞标志物（CSCM）作为FNAB中可疑结节鉴别诊断的分子标志物具有实用性。选取甲状腺乳头状癌（PTC）和甲状腺纤维腺瘤（TFA）样本对该假设进行验证。本研究使用的样本来自经FNAB诊断为甲状腺增生且诊断可疑或不确定的患者。2015年1月至2017年12月期间，这些患者在巴格达的阿尔-亚尔穆克教学医院成功接受了甲状腺切除术。所有结节样本在切除后均进行了系统的组织病理学检查。本研究选取诊断为PTC的肿瘤和诊断为纤维腺瘤（TFA）的肿瘤。总共纳入了39个PTC结节和11个TFA结节。采用定量逆转录聚合酶链反应（qRT-PCR）和免疫组织化学（IHC）方法测定两种肿瘤中CSCM ALDH1A1、CD44、ABCG2和Oct3/4的mRNA和蛋白水平。本研究表明，与良性组织相比，PTC组织中CSCM的表达水平显著升高，且CSCM表达水平与肿瘤分期、大小和性别之间存在正相关。总之，为了更精确的诊断，我们建议将这些标志物纳入目前用于区分甲状腺癌恶性肿瘤与非恶性肿瘤的方法中，以及用于PTC的分期过程。
