miRNA-146b在甲状腺结节超声引导下细针抽吸活检样本中的表达

miRNA-146b expression in ultrasound-guided fine-needle aspiration biopsy of thyroid nodules

目的探讨miRNA-146b表达在甲状腺结节超声引导下细针抽吸活检(US-FNAB)样本中的应用价值。方法选择2013年9月在上海交通大学医学院附属瑞金医院行US-FNAB的30例甲状腺结节患者。采用RT-PCR技术检测甲状腺结节US-FNAB样本中miRNA-146b的表达,并与手术后病理结果进行对照。采用t检验比较甲状腺乳头状癌(PTC)与甲状腺良性结节、有无淋巴结转移的PTC miRNA-146b表达差异。应用受试者操作特性(ROC)曲线分析miRNA-146b表达诊断甲状腺良恶性结节、PTC有无淋巴结转移的阈值、敏感度和特异度。结果 30例甲状腺结节US-FNAB样本中,病理证实PTC伴淋巴结转移10例,PTC不伴淋巴结转移10例,甲状腺良性结节10例。PTC与甲状腺良性结节、伴淋巴结转移PTC与无淋巴结转移PTC miRNA-146b表达差异均有统计学意义(t=2.539,P=0.017,t=2.431,P=0.026)。ROC曲线显示,miRNA-146b表达诊断甲状腺良恶性结节及PTC有无淋巴结转移的阈值分别为1.295、3.020,敏感度分别为80%、80%,特异度分别为80%、90%。结论甲状腺结节US-FNAB样本中miRNA-146b表达能有效鉴别PTC与甲状腺良性结节,并对PTC伴淋巴结转移有预测作用。

Objective To investigate the value of miRNA-146b expression in ultrasound-guided fine-needle aspiration biopsy（US-FNAB） of thyroid nodules. Methods Thirty patients who underwent US-FNAB of thyroid nodules before operation were collected into this study in September 2013 at Rui Jin Hospital. The diagnosis was finally confirmed by surgical pathology. miRNA-146b was measured by real-time fluorescence quantitative polymerase chain reaction（RT-PCR） in the sample of US-FNAB, and was compared with the pathologic result. T test was used to compare the expression of miRNA-146b between the papillary thyroid carcinoma（PTC） and benign thyroid nodules, and between PTC with and without lymph node metastasis. Receiver operating characteristic（ROC）curves were drawn to evaluate the diagnostic threshold, sensitivity and specificity. Results Among 30 thyroid nodules, 10 were benign, 10 were malignant with lymph node metastasis, and 10 were malignant without lymph node metastasis. The expression of miRNA-146b was up-regulated in PTC than that in benign ones（t=2.539, P=0.017）, and had significant difference between PTC with and without metastasis（t=2.431, P=0.026）. The thresholds of ROC curve in distinguishing benign and malignant thyroid nodules was 1.295 with the sensitivity of 80% and the specificity of 80%. While the thresholds of ROC curve in distinguishing PTC with and without lymph node metastasis were 3.020 with the sensitivity of 80% and the specificity of 90%. Conclusion miRNA-146b in US-FNAB can effectively identify PTC and benign thyroid nodules, and is useful for predicting lymph node metastasis.