利普液基细胞学联合miRNA-95在FNAC不确定甲状腺结节中的应用价值  

Clinical application of Liqui-prep test and miRNA-95 level in ultrasound-guided fine-needle aspiration cytopathology on evaluating indeterminate thyroid nodules

作　　者：闫永鑫 徐宁 王国凤 YAN Yong-xin(Department of general surgery,Lianyungang hospital affiliated to Xuzhou Medical University,The affiliated hospital of Kangda college of Nanjing Medical University,Lianyungang clinical college of Nanjing Medical University(The first people's hospital of Lianyungang),Lianyungang,Jiangsu,222000,China.)

机构地区：[1]徐州医科大学附属连云港医院南京医科大学康达学院第一附属医院南京医科大学连云港临床医学院(连云港市第一人民医院)普外科,江苏连云港222000 [2]徐州医科大学附属连云港医院南京医科大学康达学院第一附属医院南京医科大学连云港临床医学院(连云港市第一人民医院)内分泌科,江苏连云港222000

出　　处：《齐齐哈尔医学院学报》2020年第9期1057-1061,共5页Journal of Qiqihar Medical University

摘　　要：目的 探讨液基细胞学联合miRNA-95在甲状腺细针穿刺细胞学(Fine needle aspiration cytology,FNAC)不确定的甲状腺结节中的临床应用价值。 方法 选取2015年1月—2018年12月在连云港市一院进行超声引导下甲状腺细针穿刺标本,对细胞学诊断不确定的甲状腺结节并有手术病理的24例患者进行利普液基细胞学制片(Liquid-PRER,LPT),并应用实时荧光定量聚合酶反应检测穿刺样本中的miRNA-95的表达水平,评价利普液基细胞学联合miRNA-95对FNAC不确定甲状腺结节的诊断价值。 结果 术 后病理确诊为甲状腺癌19例(其中甲状腺乳头状癌17例,甲状腺滤泡状腺癌2例)、良性病变 5例 (滤泡性腺瘤2例、慢性淋巴细胞性甲状腺炎1例、结节性甲状腺肿2例)。与传统细胞涂片(CS)相比,LPT制片获得细胞数量较多,单层分布均匀,结构清晰和涂片背景干净,改善甲状腺癌的阳性诊断率(87.5% vs 70.8%)。恶性甲状腺结节患者FNAC中miRNA-95明显高于良性病变组(2.02±0.54 vs 0.52±0.36, P <0.05),ROC曲线分析提示miRNA-95诊断甲状腺恶性结节的AUC为0.615(95%CI:0.479~0.752),灵敏度70.8%,特异度64.3%;利普液基细胞学和miRNA-95两者联合诊断的准确率优于CS联合miRNA-95(91.7% vs 83.3%)。 结论 miRNA-95在恶性甲状腺结节中表达水平升高,与液基细胞学技术相结合有助于提高甲状腺良恶性肿瘤的诊断效能,值得在临床上推广应用。Objective To approach the value of application of Liqui-prep and miRNA-95 level in ultrasound-guided fine-needle aspiration cytology of indeterminate thyroid nodules.Methods 24 patients were enrolled in this study,they were admitted to the first affiliated hospital of Lianyungang from January 2015 to December 2018 and underwent thyroid surgery,thyroid cell samples were collected under the guidance of ultrasound,indeterminate thyroid nodules obtained by thyroid fine-needle aspiration method were used for Liqui-prep and conventional smear test.The expression levels of miRNA-95 in the ultrasound-guided fine-needle cytology were measured using real-time RT-PCR.All the jobs above were to evaluate the value of application of Liqui-prep and miRNA-95 level in ultrasound-guided fine-needle aspiration cytology of indeterminate thyroid nodules.Results After the surgery,19 cases were diagnosed thyroid cancer according to postoperative pathology(17 cases of papillary thyroid carcinoma,2 cases of follicular adenocarcinoma of thyroid gland),and 5 cases of benign lesions(2 cases of follicular adenoma,1 case of chronic lymphocytic thyroiditis,and 2 cases of nodular goiter).Positive expression of miRNA-95 in FNAC in patients with malignant thyroid nodules was higher than that in patients with benign lesions(2.02±0.54 vs 0.52±0.36,P<0.05).Results of ROC indicated that the area under the curve was 0.615(95%CI 0.479-0.752),sensitivity and specificity was 70.8%and 64.3%,respectively.The accuracy of the combination of Liqui-PREP test and miRNA-95 was higher than that of the combination of CS and miRNA-95 in the diagnosis of thyroid carcinoma(91.7%vs 83.3%).Conclusions miRNA-95 expression are increased in thyroid cancer compared with benign thyroid nodules.Its combination with liquid-prep test would help in crease the diagnosis efficiency of malignant thyroid nodules,and worth of clinical application.

关 键 词：miRNA-95 利普液基细胞学 不确定甲状腺结节 甲状腺细针穿刺 

分 类 号：R447[医药卫生—诊断学]