Chijioke O
Institut für Pathologie, Universitätsspital Basel, Schönbeinstraße 40, 4031, Basel, Schweiz.
Pathologe. 2022 Mar;43(2):105-108. doi: 10.1007/s00292-021-01049-x. Epub 2022 Jan 10.
In the evaluation of thyroid nodules, cytopathology of thyroid fine-needle aspiration specimens plays a central role. Established classification schemes should be used. In the case of indeterminate cytology, additional molecular tests may be used. However, the stratification of indeterminate thyroid nodules into malignant and benign lesions based on molecular tests alone, apart from costly commercial assays from US vendors, has so far been clearly limited. Molecular testing of single genetic alterations that can confirm malignancy in papillary, poorly differentiated, and anaplastic thyroid carcinomas is helpful and relatively easy to perform. However, negative test results by no means exclude malignant neoplasia. Predictive markers for single entities (BRAF V600E, RET mutations and RET fusions) should be tested in all advanced thyroid carcinomas.
在甲状腺结节评估中，甲状腺细针穿刺标本的细胞病理学起着核心作用。应使用既定的分类方案。对于细胞学结果不确定的情况，可采用额外的分子检测。然而，仅基于分子检测将不确定的甲状腺结节分层为恶性和良性病变，除了美国供应商昂贵的商业检测外，目前显然受到限制。对能在乳头状、低分化和未分化甲状腺癌中确诊恶性肿瘤的单一基因改变进行分子检测是有帮助的，且相对容易操作。然而，检测结果为阴性绝不能排除恶性肿瘤。所有晚期甲状腺癌均应检测单一实体的预测标志物（BRAF V600E、RET突变和RET融合）。
