Cytology and mRNA expression analysis of fine needle aspirates of thyroid nodules in an East German region with borderline iodine deficiency.
S KargerC EngelhardtM EszlingerA TönjesF HerrmannP MüllerTh SchmidtC L WeissH DralleF LippitzschA TannapfelDagmar FuhrerPublished in: Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme (2006)
Fine needle aspiration cytology (FNAC) is widely recommended as an important tool for pre-operative identification of malignancy in patients with nodular thyroid disease. To assess the diagnostic contribution of FNAC and the potential of quantitative mRNA analysis in fine needle aspirates in daily practice, we conducted a prospective study in thyroid clinics (n=2) and endocrine practices (n=3), respectively in an East German region with borderline iodine deficiency. Two-hundred and forty-four consecutive FNACs were obtained over a period of 2 years (2002-2004) from euthyroid patients presenting for first evaluation of a solitary thyroid nodule. The mean nodule size for FNAC was 27 mm (range: 10-79 mm). In 55% of patients FNAC was performed after scintiscan detection of a cold or normal functioning thyroid nodule (CTN), while in the remainder FNAC was performed as a primary investigation. FNAC outcomes were: 57.8% benign, 22.1% indeterminate, 2.5% suspicious for malignancy, 17.6% non-diagnostic. Messenger RNA levels for a house keeping gene (beta-actin) and a thyroid specific marker (thyroglobulin, Tg) were studied as basic molecular markers using real-time PCR. Both in the IN VIVO and EX VIVO FNA series, beta-actin and Tg mRNA levels were positively correlated with the thyrocyte cell yield/respective FNA smear. However, subgroup analysis showed that FNAC with histologically confirmed follicular thyroid cancer and/or microfollicular adenoma exhibited significantly lower Tg mRNA expression despite high beta-actin levels. Sufficient mRNA quantities were obtained in >90% of FNA specimen to allow quantitative mRNA analysis of at least 5 further genes. In conclusion, quantitative mRNA analysis is feasible in FNA on a routine basis and provides a perspective for a molecular distinction of thyroid nodules, once specific marker genes have been defined for benign and malignant thyroid tumours respectively.
Keyphrases
- fine needle aspiration
- ultrasound guided
- end stage renal disease
- real time pcr
- primary care
- newly diagnosed
- chronic kidney disease
- ejection fraction
- genome wide
- healthcare
- high resolution
- prognostic factors
- computed tomography
- gene expression
- air pollution
- binding protein
- transcription factor
- physical activity
- patient reported outcomes
- clinical trial
- peritoneal dialysis
- high grade
- insulin resistance
- risk assessment
- mycobacterium tuberculosis
- clinical practice
- copy number
- dna methylation
- adipose tissue
- metabolic syndrome
- single cell
- sensitive detection
- genome wide identification
- human health
- patient reported
- contrast enhanced