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Los nódulos tiroideos son muy frecuentes y afectan aproximadamente al 10% de la población general. La citología tras aspiración con aguja fina es uno de los puntos de partida en la evaluación del nódulo tiroideo y su precisión es excelente, pero las muestras de citología sospechosas o indeterminadas son un dilema diagnóstico y de conducta a seguir. Se ha intentado buscar un marcador o marcadores moleculares útiles para la ayuda al diagnóstico citológico y se han analizado más de 70 moléculas con este propósito. En esta revisión se orienta sobre todo al estudio de algunos, como peroxidasa tiroidea, tiroglobulina, telomerasa, galectina 3, RET/PTC y proteína p53; de ellos, unos pocos, como la peroxidasa tiroidea, la tiroglobulina y la galectina 3, se pueden estudiar en el laboratorio habitual y son prometedores, aunque no cumplen todos los criterios requeridos para su uso en la práctica clínica. La guía estadounidense y el consenso europeo para la conducta a seguir ante el nódulo tiroideo y el cáncer diferenciado de tiroides no recomiendan su utilización, ya que las evidencias que presentan son insuficientes.
Palabras clave:
Citología tras punción-aspiración con aguja fina
Peroxidasa tiroidea
Tiroglobulina
Telomerasa
Galectina 3
RET/PTC
Proteína p53
Thyroid nodules are common, affecting approximately 10% of the general population. Fine-needle aspiration biopsy has become the mainstay of thyroid nodule evaluation. The overall accuracy of this procedure is excellent but suspicious or indeterminate cytological samples can pose a diagnostic and management dilemma. In the attemptto find a molecular marker useful as an aid for cytological diagnosis, at least 70 molecular markers have been analyzed in thyroid nodules. This review focuses on some potential markers, such as thyroid peroxidase, thyroglobulin, telomerase, galectin-3, RET/PTC and p53; a few of these potential markers, such as thyroid peroxidases, thyroglobulin and galectin-3, can be studied in routine pathology laboratories and are promising, but do not yet fulfill the criteria for use in clinical practice. The American guidelines and the European consensus for the management of thyroid nodules and differentiated thyroid cancer do not recommend their use because the evidence provided is insufficient.
Key words:
Fine-needle aspiration biopsy
Thyroid peroxidase
Thyroglobulin
Telomerase
Galectin-3
RET/PTC
p53
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