open access

Vol 57, No 4 (2006)
Original papers
Published online: 2006-07-07
Submitted: 2013-02-15
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Indications for surgery of thyroid cancer based on bioptate molecular examination

Elżbieta Gubała, Tomasz Olczyk, Agnieszka Pawlaczek, Daria Handkiewicz-Junak, Józef Roskosz, Jolanta Krajewska, Marcin Zeman, Ewa Chmielik, Aleksandra Kukulska, Agnieszka Czarniecka, Jan Włoch
Endokrynologia Polska 2006;57(4):396-402.

open access

Vol 57, No 4 (2006)
Original papers
Published online: 2006-07-07
Submitted: 2013-02-15

Abstract

Introduction: In differentiated thyroid cancer (DTC) the differentiation between reactive and metastatic lymph nodes is difficult at the early stages of metastasis. The aim of the study was to assess the results of fine needle aspiration (FNA) samples examination by the use of RT-PCR for Tg mRNA. The special attention was directed to the evaluation of specificity of TgRNA estimation.
Material and methods: The group consisted of 193 DTC patients with suspicion of lymph node recurrence and at least one positive RT-PCR result. Thyroglobulin RT-PCR was conducted in residual material left after preparation of cytological smears from FNA specimens. Primer spanning exons 3-5 were used with 39 cycles of PCR. RNA isolation control and cDNA amplification were carried out using GAPDH starters. 308 lymph node biopsies were included.
Results: 246 positive results for Tg RNA were observed in the analyzed group, 71.1% confirmed by FNA. Among other 71 results, in which cytological examination did not correspond unequivocally to molecular findings, in 34 metastases were confirmed both by cytological and clinical examination. There were 11 patients operated due to the positive serial molecular examination only. In 10 (91%) of them DTC metastases were confirmed. So, the positive predictive value of the molecular result ranged between 75-89% and the negative one was 100%.
Conclusions: In DTC patients RT-PCR Tg mRNA is helpful in qualification of suspicious lymph nodes to surgery in DTC patients. At the negative cytological finding, the positive molecular result constitutes an indication for early surgery.

Abstract

Introduction: In differentiated thyroid cancer (DTC) the differentiation between reactive and metastatic lymph nodes is difficult at the early stages of metastasis. The aim of the study was to assess the results of fine needle aspiration (FNA) samples examination by the use of RT-PCR for Tg mRNA. The special attention was directed to the evaluation of specificity of TgRNA estimation.
Material and methods: The group consisted of 193 DTC patients with suspicion of lymph node recurrence and at least one positive RT-PCR result. Thyroglobulin RT-PCR was conducted in residual material left after preparation of cytological smears from FNA specimens. Primer spanning exons 3-5 were used with 39 cycles of PCR. RNA isolation control and cDNA amplification were carried out using GAPDH starters. 308 lymph node biopsies were included.
Results: 246 positive results for Tg RNA were observed in the analyzed group, 71.1% confirmed by FNA. Among other 71 results, in which cytological examination did not correspond unequivocally to molecular findings, in 34 metastases were confirmed both by cytological and clinical examination. There were 11 patients operated due to the positive serial molecular examination only. In 10 (91%) of them DTC metastases were confirmed. So, the positive predictive value of the molecular result ranged between 75-89% and the negative one was 100%.
Conclusions: In DTC patients RT-PCR Tg mRNA is helpful in qualification of suspicious lymph nodes to surgery in DTC patients. At the negative cytological finding, the positive molecular result constitutes an indication for early surgery.
Get Citation

Keywords

differentiated thyroid cancer (DTC); reactive and metastatic lymph nodes; cytological finding; molecular result; RT-PCR Tg mRNA

About this article
Title

Indications for surgery of thyroid cancer based on bioptate molecular examination

Journal

Endokrynologia Polska

Issue

Vol 57, No 4 (2006)

Pages

396-402

Published online

2006-07-07

Bibliographic record

Endokrynologia Polska 2006;57(4):396-402.

Keywords

differentiated thyroid cancer (DTC)
reactive and metastatic lymph nodes
cytological finding
molecular result
RT-PCR Tg mRNA

Authors

Elżbieta Gubała
Tomasz Olczyk
Agnieszka Pawlaczek
Daria Handkiewicz-Junak
Józef Roskosz
Jolanta Krajewska
Marcin Zeman
Ewa Chmielik
Aleksandra Kukulska
Agnieszka Czarniecka
Jan Włoch

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