Department of Pathomorphology, Faculty of Medicine, Jagiellonian University Medical College, Grzegorzecka 16, 31-531 Krakow, Poland.
Department of Pathology, University Children Hospital in Krakow, 30-663 Krakow, Poland.
Int J Mol Sci. 2023 Oct 13;24(20):15131. doi: 10.3390/ijms242015131.
The incidence of thyroid nodules (TNs) is estimated at 36.5% and 23% in females and males, respectively. A single thyroid nodule is usually detected during ultrasound assessment in patients with symptoms of thyroid dysfunction or neck mass. TNs are classified as benign tumours (non-malignant hyperplasia), benign neoplasms (e.g., adenoma, a non-invasive follicular tumour with papillary nuclear features) or malignant carcinomas (follicular cell-derived or C-cell derived). The differential diagnosis is based on fine-needle aspiration biopsies and cytological assessment (which is burdened with the bias of subjectivity). Raman spectroscopy (RS) is a laser-based, semiquantitative technique which shows for oscillations of many chemical groups in one label-free measurement. RS, through the assessment of chemical content, gives insight into tissue state which, in turn, allows for the differentiation of disease on the basis of spectral characteristics. The purpose of this study was to report if RS could be useful in the differential diagnosis of TN. The Web of Science, PubMed, and Scopus were searched from the beginning of the databases up to the end of June 2023. Two investigators independently screened key data using the terms "Raman spectroscopy" and "thyroid". From the 4046 records found initially, we identified 19 studies addressing the differential diagnosis of TNs applying the RS technique. The lasers used included 532, 633, 785, 830, and 1064 nm lines. The thyroid RS investigations were performed at the cellular and/or tissue level, as well as in serum samples. The accuracy of papillary thyroid carcinoma detection is approx. 90%. Furthermore, medullary, and follicular thyroid carcinoma can be detected with up to 100% accuracy. These results might be biased with low numbers of cases in some research and overfitting of models as well as the reference method. The main biochemical changes one can observe in malignancies are as follows: increase of protein, amino acids (like phenylalanine, tyrosine, and tryptophan), and nucleic acid content in comparison with non-malignant TNs. Herein, we present a review of the literature on the application of RS in the differential diagnosis of TNs. This technique seems to have powerful application potential in thyroid tumour diagnosis.
甲状腺结节 (TNs) 的发病率估计在女性和男性中分别为 36.5%和 23%。在有甲状腺功能障碍或颈部肿块症状的患者中，超声检查通常会发现单个甲状腺结节。TNs 分为良性肿瘤（非恶性增生）、良性肿瘤（例如腺瘤，一种具有乳头状核特征的非侵袭性滤泡肿瘤）或恶性癌（滤泡细胞衍生或 C 细胞衍生）。鉴别诊断基于细针抽吸活检和细胞学评估（存在主观性偏见的负担）。拉曼光谱 (RS) 是一种基于激光的半定量技术，可在一次无标记测量中显示许多化学基团的振动。RS 通过评估化学含量，深入了解组织状态，从而根据光谱特征对疾病进行区分。本研究旨在报告 RS 是否可用于 TN 的鉴别诊断。Web of Science、PubMed 和 Scopus 从数据库开始搜索到 2023 年 6 月底。两名研究人员使用“拉曼光谱”和“甲状腺”这两个术语独立筛选关键数据。从最初发现的 4046 条记录中，我们确定了 19 项研究，这些研究应用 RS 技术对 TN 进行了鉴别诊断。使用的激光器包括 532、633、785、830 和 1064nm 线。甲状腺 RS 研究在细胞和/或组织水平以及血清样本中进行。乳头状甲状腺癌的检测准确率约为 90%。此外，髓样和滤泡性甲状腺癌的检测准确率可达 100%。这些结果可能存在偏倚，原因是一些研究中的病例数量较少、模型过度拟合以及参考方法。在恶性肿瘤中可以观察到的主要生化变化如下：与非恶性 TN 相比，蛋白质、氨基酸（如苯丙氨酸、酪氨酸和色氨酸）和核酸含量增加。在此，我们对 RS 在 TN 鉴别诊断中的应用文献进行了综述。该技术在甲状腺肿瘤诊断中似乎具有强大的应用潜力。
