Session: MON 471-496-Thyroid Neoplasia & Case Reports
Poster Board MON-473
Methods: This study included 78 consecutive patients with a single thyroid solid nodule who underwent surgery for a cytology result of indeterminate (n=39) or indicative /suspicious of malignancy (n= 39) at fine needle aspiration. USE was performed using a real-time instrument (Hitachi, Logos EUB 8500 with a 10 MHz linear transducer). Tissue stiffness was scored from 1 (high elasticity) to 2-3 (low elasticity). Gal-3 and FN-1 mRNA quantification was performed using the two-step Real-Time Quantitative RT-PCR Rotor Gene Sybr Green PCR Kit (Qiagen) on a Rotor Gene 6000 (Qiagen) instrument. Beta-Actin mRNA was used as an internal control. Pooled normal thyroid tissue was used as external control. The comparative threshold cycle (Ct) method, defined as 2-ΔΔCt, were used for the calculation of fold amplification of each sample versus external control.
Gal-3 and FN-1 mRNA expression was normalized, positive and negative z scores indicating a value above or below the mean, respectively. The converted z scores were then aggregated into one large set, identifying two different categories: ‘low expression’ (negative z score), ‘high expression’ (positive z score). Tumor fibrosis, evaluated using haematoxylin and eosin staining by both optical and digital microscope analysis, was scored as the percentage of fibrosis with respect to tumor cell-occupied area.
Results: Score 1 at USE was found in 33 cases, 32 benign lesions and 1 carcinoma at histology; score 2-3 in 45 cases, all carcinomas. The low elasticity was highly predictive of malignancy (p<0,0001).
High expression of Gal-3 was found in 33/45 nodules with score 2-3 at USE and only in 2/32 nodules with score 1 (p<0.0001). High expression of FN-1 was found in 26/45 nodules with score 2-3 at USE and in none with score 1 (p<0.0001). The degree of fibrosis was 10,46% + 17,15 in nodules with score 1 and 22,5% + 25,73 in those with score 2-3 (p=0,025).
In conclusion these data: i) confirm that low elasticity at USE is highly correlated with malignancy; ii) suggest that low elasticity is linked with fibrosis and higher expression of Gal-3, FN-1, involved in tumor progression.
Disclosure: PV: Coinvestigator, Bracco S.p.A.. Nothing to Disclose: TR, MS, VL, LT, RG, NB, AP, FB
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