Winzer R, Schmutzler C, Jakobs T C, Ebert R, Rendl J, Reiners C, Jakob F, Köhrle J
Klinische Forschergruppe, Medizinische Poliklinik, University of Würzburg, Germany.
Thyroid. 1998 Nov;8(11):981-7. doi: 10.1089/thy.1998.8.981.
Currently, fine-needle aspiration cytology is a valuable tool in the routine diagnosis of suspicious thyroid nodules. We present a very sensitive method for the molecular analysis of the expression of several genes important for normal thyroid function in parallel to the cytological diagnosis. We adapted reverse transcriptase polymerase chain reaction (RT-PCR) to amplify thyroid-typical mRNAs in samples of thyroid carcinoma cells as small as those obtained by fine-needle aspiration biopsy (FNAB), ie, 100-1000 cells, and applied this procedure to four routinely taken FNABs. Gene products such as thyroglobulin (Tg), thyroid-stimulating hormone-receptor (TSHr), sodium/iodide-symporter (NIS), type I iodothyronine-5'-deiodinase (DI), and type II iodothyronine-5'-deiodinase (DII) were analyzed. To establish RT-PCR protocols, serial dilutions of follicular thyroid carcinoma cells, FTC-133, which express these genes at low levels, were initially used for RNA isolation. Successful RNA isolation and reverse transcription were checked by the amplification of beta-actin mRNA. We detected the mRNAs coding for Tg in as little as 10 cells, for NIS in 100 cells, and for TSHr, DI, and DII in 10,000 cells. After preparing cytological smears of four routinely taken FNABs, all above-mentioned thyroid-typical mRNAs were observed by using the material remaining in the needle for RNA isolation followed by RT-PCR. This method offers the possibility of obtaining two different types of information from the same routinely taken thyroid FNAB: the cytological diagnosis and the expression pattern of several diagnostically relevant genes. Therefore, a more specific diagnosis could be rendered in the preoperative state, and may lead to more specific therapy.
目前,细针穿刺细胞学检查是常规诊断可疑甲状腺结节的一项重要手段。我们提出了一种非常灵敏的方法,可在进行细胞学诊断的同时,对正常甲状腺功能所必需的几个基因的表达进行分子分析。我们采用逆转录聚合酶链反应(RT-PCR),以扩增甲状腺癌细胞样本中的甲状腺特异性mRNA,这些样本小至通过细针穿刺活检(FNAB)获得的样本,即100 - 1000个细胞,并将此方法应用于4例常规采集的FNAB样本。对甲状腺球蛋白(Tg)、促甲状腺激素受体(TSHr)、钠/碘同向转运体(NIS)、Ⅰ型碘甲状腺原氨酸5'-脱碘酶(DI)和Ⅱ型碘甲状腺原氨酸5'-脱碘酶(DII)等基因产物进行了分析。为建立RT-PCR方案,最初使用低水平表达这些基因的滤泡状甲状腺癌细胞FTC-133的系列稀释液进行RNA提取。通过扩增β-肌动蛋白mRNA来检查RNA提取和逆转录是否成功。我们检测到,低至10个细胞中就能检测到编码Tg的mRNA,100个细胞中能检测到NIS的mRNA,10000个细胞中能检测到TSHr、DI和DII的mRNA。在制备4例常规采集的FNAB样本的细胞学涂片后,利用针内剩余材料进行RNA提取,随后进行RT-PCR,观察到了上述所有甲状腺特异性mRNA。该方法能够从同一例常规采集的甲状腺FNAB样本中获取两种不同类型的信息:细胞学诊断以及几个诊断相关基因的表达模式。因此,在术前状态下可做出更具特异性的诊断,并可能带来更具针对性的治疗。