细针穿刺标本中端粒酶活性检测对甲状腺癌的诊断

Detection of telomerase activity by fine needle aspiration biopsy in the diagnosis of thyroid cancer

目的 探讨甲状腺肿块细针穿刺活检 (FNAB )标本中端粒酶活性检测在甲状腺癌术前诊断中的应用价值。方法 在超声引导下穿刺抽取甲状腺组织FNAB标本 ,分别进行细胞学病理检查和端粒酶活性检测。以术后石蜡病理切片结果为最终标准 ,对以上两者结果进行对照、分析。结果 在 3 2例甲状腺癌中 ,FNAB的正确诊断率为 43 .8%(14 /3 2 ) ,端粒酶活性阳性率为 75 .0 %(2 4/3 2 ) ,两者相比有显著差异 (P <0 .0 5 )。在 18例甲状腺癌被FNAB诊断为“可疑阳性”、“取材不够”、“阴性”及“甲状腺炎”者中 ,14例显示端粒酶活性 ,阳性率为 77.8%(14 /18)。两者联合诊断率可提高至 87.5 %。结论 端粒酶活性检测是FNAB很好的辅助诊断方法 ,两者联合应用可明显提高FNAB标本的阳性诊断率。

Objective To investigate the value of detection of telomerase activity by fine needle aspiration biopsy (FNAB) of thyroid mass in the preoperative diagnosis of thyroid cancer. Methods Comparation of the results of detection of telomerase activity and biopsy of the of samples of thyroid masses aspirated by fine needle guided by B-us were performed .The results were compared to the postoperative pathological results. Results Of the 32 cases of thyroid carcinomas, the correct diagnostic rate of FNAB was 43.8%, while the positive rate of telomerase activity was 75.0%, the difference between the two examinations was significant ( P <0.05). In 18 FNAB samples diagnosed as ' suspicious', 'inadequate', ' negative', and ' thyroiditis ',14(77.8%) had telomerase activity expression. The diagnostic rate of combination of the two methods was 87.5%. Conclusions The detection of telomerase activity is a good adjunct method to FNAB.Combination of detecting trlomerase activify and FNBA can imporove the diagnosis of thyroid cancer in the FNAB samples.