New technology in thyroid fine-needle aspiration

摘要

There have been many recent developments in thyroid fine-needle aspiration (FNA). Thyroid fine-needle aspiration was traditionally practised freehand although in recent years the majority of thyroid fine-needle aspirations are now taken under ultrasound guidance. While thyroid fine-needle aspiration practice has changed relatively little, new molecular technologies have developed apace. The principal new technology is the application of molecular markers to thyroid fine-needle aspirates. The prototypical marker is BRAF V600E. Mutations of the BRAF V600 gene in thyroid cancer were described over 10 years ago and are quite common in thyroid cancer, melanoma and adenocarcin-omas, such as lung and colorectal tumours. Mutation of the BRAF V600E within primary tumours of the thyroid is a highly specific indicator of thyroid cancer and most published series indicate specificity for cancer of 100%, although only approximately 50% of all thyroid primary tumours show BRAF V600E mutations as mutations are confined to papillary carcinoma, or tumours which may show a papillary component, such as anaplastic carcinoma with papillary differentiation.