Fine-needle aspiration biopsy (FNA) is usually applied to distinguish benign from malignant
thyroid nodules. However, cytological analysis cannot always allow a proper diagnosis. We believe that the improvement of the diagnostic capability of pre-surgical FNA could avoid unnecessary
thyroidectomy. In a previous study, we performed a
proteome analysis to examine FNA collected after
thyroidectomy. With the present study, we examined the applicability of these results on pre-surgical FNA. We collected pre-surgical FNA from 411 consecutive patients, and to obtain a correct comparison with our previous results, we processed only benign (n=114), papillary classical variant (cPTC) (n=34) and papillary tall cell variant (TcPTC) (n=14) FNA. We evaluated levels of five
proteins previously found up-regulated in
thyroid cancer with respect to benign nodules. ELISA and western blot (WB) analysis were used to assay levels of
L-lactate dehydrogenase B chain (LDHB),
Ferritin heavy chain,
Ferritin light chain,
Annexin A1 (ANXA1), and
Moesin in FNA. ELISA assays and WB analysis confirmed the increase of LDHB,
Moesin, and ANXA1 in pre-surgical FNA of thyroid papillary
cancer. Sensitivity and specificity of ANXA1 were respectively 87 and 94% for cPTC, 85 and 100% for TcPTC. In conclusion, a proteomic analysis of FNA from patients with
thyroid nodules may help to distinguish benign versus malignant
thyroid nodules. Moreover, ANXA1 appears to be an ideal candidate given the high sensitivity and specificity obtained from ROC curve analysis.