Koç Öztürk Fulya, Usta Özdemir Semra, Karakılıç Ersen, Sılan Fatma
Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Nuclear Medicine, Çanakkale, Türkiye.
Çanakkale Onsekiz Mart University Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology and Metabolism, Çanakkale, Türkiye.
Mol Imaging Radionucl Ther. 2025 Jun 3;34(2):97-106. doi: 10.4274/mirt.galenos.2025.85429.
This study aims to evaluate the effectiveness and role of telomere length measurements in leukocytes, plasma free cell DNA (cfDNA), and biopsy cells, along with technetium-99m (Tc-99m) methoxyisobutylisonitrile (MIBI) scintigraphy, as non-invasive methods for diagnosing malignant thyroid lesions.
Data from 128 patients, who underwent ultrasound, Tc-99m MIBI scintigraphy, and fine-needle biopsy with a preliminary diagnosis of malignant thyroid nodules, were analyzed. In 98 patients, telomere lengths in leukocytes (from blood), cfDNA (from plasma), and biopsy cells were measured using the quantitative polymerase chain reaction method, and the relative telomere/single copy gene (T/S) ratio was calculated. Based on cytological examination results, patients were categorized into three groups: malignant, benign, and suspicious. Group differences were analyzed using the Kruskal-Wallis and Chi-square tests, and correlations between variables were examined with Spearman correlation analysis.
The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of Tc-99m MIBI scintigraphy for diagnosing malignant thyroid nodules were 64.70%, 79.16%, 29.72%, 83.51%, and 67.96%, respectively. While these results align with the literature, the positive predictive value was notably lower. No significant differences were observed in telomere lengths (T/S ratios) in leukocytes, plasma, or tissue between the groups.
Tc-99m MIBI scintigraphy demonstrates reasonable diagnostic accuracy for identifying malignancy in thyroid nodules. Contrary to limited reports, telomere length measurements may not be a reliable method for predicting thyroid malignancy. Larger studies are needed to further explore these findings.
本研究旨在评估白细胞、血浆游离细胞DNA（cfDNA）和活检细胞中端粒长度测量以及锝-99m（Tc-99m）甲氧基异丁基异腈（MIBI）闪烁扫描作为诊断甲状腺恶性病变的非侵入性方法的有效性和作用。
分析128例经超声、Tc-99m MIBI闪烁扫描及细针穿刺活检初步诊断为甲状腺结节恶性病变患者的数据。对98例患者，采用定量聚合酶链反应法测量白细胞（血液中）、cfDNA（血浆中）和活检细胞中的端粒长度，并计算相对端粒/单拷贝基因（T/S）比值。根据细胞学检查结果，将患者分为三组：恶性、良性和可疑。采用Kruskal-Wallis检验和卡方检验分析组间差异，用Spearman相关分析检验变量之间的相关性。
Tc-99m MIBI闪烁扫描诊断甲状腺恶性结节的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为64.70%、79.16%、29.72%、83.51%和67.96%。虽然这些结果与文献一致，但阳性预测值明显较低。各组白细胞、血浆或组织中的端粒长度（T/S比值）未观察到显著差异。
Tc-99m MIBI闪烁扫描在识别甲状腺结节恶性病变方面显示出合理的诊断准确性。与有限的报道相反，端粒长度测量可能不是预测甲状腺恶性病变的可靠方法。需要更大规模的研究来进一步探索这些发现。
