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首页> 外文期刊>Egyptian Journal of Medical Human Genetics >Molecular detection of circulating thyroid specific transcripts (TSHR/Tg-mRNAs) in thyroid cancer patients: Their diagnostic significance
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Molecular detection of circulating thyroid specific transcripts (TSHR/Tg-mRNAs) in thyroid cancer patients: Their diagnostic significance

机译：甲状腺癌患者中循环甲状腺特异性转录本（TSHR / Tg-mRNA）的分子检测：其诊断意义

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Thyroid cancer is the most prevalent endocrine malignancy. The preoperative diagnosis of differentiated thyroid cancer (DTC) that relies solely on fine-needle aspiration (FNAC) biopsy, sometimes possesses conflicting results. New molecular markers for thyroid cancer have been investigated with most of them based on the detection in thyroid nodules or tumor tissue specimens. Recently, it was possible to detect thyroid cancer cells in the circulation by measuring the mRNA of thyroid specific genes. Among these, thyroglobulin and more recently thyroid stimulating hormone receptor mRNAs, TSHR/Tg-mRNAs in peripheral blood might serve as cancer-specific markers. These have become promising new circulating markers for thyroid cancer. The purpose of this study is to assess TSHR/Tg-mRNAs as diagnostic molecular markers for thyroid cancer and if they can be used preoperatively in synergy with FNAC. This study was performed on 60 subjects; 20 healthy volunteers and 40 patients; including 16 patients with benign thyroid diseases, 24 patients with thyroid cancer; 18 patients with newly diagnosed (DTC) and 6 patients with recurrent thyroid cancer. Diagnosis of cancer was based on FNAC and histopathology of surgical specimens. All subjects had TSHR/Tg-mRNAs in peripheral blood measured by reverse transcriptase (RT)-PCR. Based on cytology/pathology; 18 patients had newly diagnosed DTC and 11 had benign thyroid disease. Preoperative FNAC was performed on 29 of 40 patients; FNAC was diagnostic in 11/18 of malignant lesions (61.1%), in 8/11 of benign lesions (72.7%), while 10/29 (34.5%) were indeterminate. TSHR/Tg-mRNAs correctly diagnosed DTC in 20/24 and 19/24 (sensitivity 83.3% and 79.1%) and benign disease in 14/16 and 13/16 (specificity 87.5% and 81.3%), respectively. With indeterminate FNA, TSHR/Tg-mRNAs correctly diagnosed DTC (follicular type) in 5/7 and benign disease in 2/3 (combined sensitivity 71.4%; specificity 66.7%). There was high concordance between RT-PCR results for TSHR-mRNA and Tg-mRNA. Of the controls 19/20 (95%) and 16/20 (80%) were negative for both TSHR- and Tg-mRNAs. With the use of a carefully selected primer pair and qualitative RT-PCR; our results indicate that TSHR/Tg-mRNAs in peripheral blood are both equally sensitive and specific markers for detection of thyroid cancer cells. Combining TSHR/Tg-mRNAs and FNAC and ultrasound enhances the preoperative detection of cancer in patients with thyroid nodules, reducing unnecessary surgeries and correctly classified most follicular cancers and could have spared surgery in patients with benign disease.
机译：甲状腺癌是最普遍的内分泌恶性肿瘤。仅依靠细针穿刺活检（FNAC）活检的分化型甲状腺癌（DTC）的术前诊断有时会产生矛盾的结果。已经根据甲状腺结节或肿瘤组织标本中的检测结果，研究了大多数用于甲状腺癌的新分子标记。最近，通过测量甲状腺特异性基因的mRNA，可以检测循环中的甲状腺癌细胞。其中，外周血中的甲状腺球蛋白和最近的甲状腺刺激激素受体mRNA，TSHR / Tg-mRNA可能是癌症特异性标记。这些已成为有希望的甲状腺癌新的循环标志物。这项研究的目的是评估TSHR / Tg-mRNAs作为甲状腺癌的诊断分子标志物，以及它们是否可以在术前与FNAC协同使用。这项研究针对60位受试者进行; 20名健康志愿者和40名患者;其中，甲状腺良性疾病16例，甲状腺癌24例。新诊断的18例患者（DTC）和复发性甲状腺癌的6例患者。癌症的诊断基于FNAC和手术标本的组织病理学。通过逆转录酶（RT）-PCR测量，所有受试者的外周血中都有TSHR / Tg-mRNA。基于细胞学/病理学;初诊DTC的患者18例，甲状腺良性疾病的11例。 40名患者中有29名接受了术前FNAC治疗; FNAC诊断为11/18的恶性病变（61.1％），8/11的良性病变（72.7％），而10/29（34.5％）不确定。 TSHR / Tg-mRNA分别在20/24和19/24（敏感性83.3％和79.1％）和14/16和13/16（特异性87.5％和81.3％）中正确诊断出DTC。使用不确定的FNA，TSHR / Tg-mRNA可正确诊断DTC（卵泡型）为5/7，良性疾病为2/3（综合敏感性为71.4％;特异性为66.7％）。 TSHR-mRNA和Tg-mRNA的RT-PCR结果高度一致。在对照中，TSHR-mRNA和Tg-mRNA均为19/20（95％）和16/20（80％）阴性。使用精心选择的引物对和定性RT-PCR;我们的结果表明，外周血中的TSHR / Tg-mRNA既是检测甲状腺癌细胞的敏感标志物，又是特异性标志物。将TSHR / Tg-mRNA与FNAC和超声相结合可增强甲状腺结节患者的术前检测，减少不必要的手术并正确分类大多数滤泡癌，并且在良性疾病患者中可以避免手术。

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