Información del artículo
La punción-aspiración con aguja fina (PAAF) es generalmente aceptada como la técnica de elección en el estudio del nódulo tiroideo; sin embargo, su interpretación clínica tiene algunas limitaciones. Por ello, en los últimos años se ha propuesto complementar la citología convencional con marcadores moleculares detectados mediante técnicas inmunoquímicas. Los marcadores más estudiados son TPO47 y galectina-3, ambos con notable sensibilidad y especificidad. CD44v6 es menos útil de lo que se pensaba al principio. Sobre pRB, c-Met, CK-19, HBME-1, COX-2 y hTERT, aunque muy prometedores, se dispone de menos experiencia. Existe una importante lista de otros potenciales marcadores de malignidad que están a la espera de ser analizados. Todos estos marcadores, empleados aisladamente o en combinación, podrían mejorar de manera sustancial la exactitud diagnóstica de la PAAF en los casos más difíciles y así evitar tiroidectomías innecesarias.
Palabras clave:
Tiroides
PAAF
TPO47
Galectina-3
Fine-needle aspiration biopsy (FNAB) is generally accepted as the method of choice for the study of thyroid nodule, but its clinical interpretation presents some limitations. For this reason, additional analyses of molecular markers using immunochemistry have been proposed in combination with conventional cytology. The best studied markers are TPO47 and galectin-3, both of which have remarkable sensitivity and specificity. CD44v6 seems to be less useful than was previously expected. Although pRB, c-Met, CK-19, HBME-1, COX-2 and hTERT are very promising, experience with these markers is limited. A long list of other potential markers of malignancy remain to be analyzed. All these markers, used alone or in combination, may substantially increase the diagnostic accuracy of FNAB in difficult cases and thus reduce unnecessary thyroidectomies.
Key words:
Thyroid
FNAB
TPO47
Galectin-3
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