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Cytopathology ; 26(5): 288-96, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25487739

RESUMEN

OBJECTIVES: The application of molecular tests to thyroid fine needle aspiration (FNA) has been shown to be a valuable tool to better refine the pre-operative malignant risk of patients with indeterminate cytology results. In this study, we investigated the feasibility of using the laser capture microdissection (LCM) technique to obtain DNA and RNA for molecular tests in routine thyroid FNA smears. METHODS: Nine coupled FNA and histological retrospective cases and 31 prospective FNA cases with a follicular neoplasm/suspicious for a follicular neoplasm (FN/SFN) diagnosis were included in this study. Both cytological and histological specimens were investigated by direct sequencing and reverse transcription-polymerase chain reaction (RT-PCR) for BRAF and RAS mutations and for PAX8/PPARG and RET/PTC rearrangements, respectively. RESULTS: LCM yielded good DNA and RNA quality in all cases (100%) in both series, irrespective of the staining used (Giemsa, Papanicolaou, immunostain for thyroglobulin) and the cytology technique (conventional or liquid-based preparations). Total mutations found in the FNA and in the corresponding histological specimen in both series were: one PAX8/PPARG rearrangement in a follicular carcinoma (FC), four NRAS mutations [in two FCs, one papillary carcinoma and one follicular adenoma (FA)] and one HRAS mutation in one FA. The sensitivity was 67% and the specificity was 91%. CONCLUSIONS: LCM is a valuable tool to obtain good quality DNA and RNA for molecular tests in cytological material from thyroid FNA, and can be a useful option in the management of patients with an FN/SFN FNA diagnosis.


Asunto(s)
Adenocarcinoma Folicular/diagnóstico , Adenocarcinoma Folicular/patología , Adenoma/diagnóstico , Adenoma/patología , Glándula Tiroides/patología , Neoplasias de la Tiroides/diagnóstico , Neoplasias de la Tiroides/patología , Adenocarcinoma Folicular/genética , Adenoma/genética , Biopsia con Aguja Fina/métodos , Citodiagnóstico/métodos , ADN/genética , Femenino , Humanos , Captura por Microdisección con Láser/métodos , Masculino , Persona de Mediana Edad , Técnicas de Diagnóstico Molecular/métodos , Mutación/genética , Factor de Transcripción PAX8 , PPAR gamma/genética , Factores de Transcripción Paired Box/genética , Estudios Prospectivos , Proteínas Proto-Oncogénicas B-raf/genética , Proteínas Proto-Oncogénicas c-ret/genética , ARN/genética , Estudios Retrospectivos , Neoplasias de la Tiroides/genética , Proteínas ras/genética
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