Human telomerase reverse transcriptase (hTERT) gene expression in FNA samples from thyroid neoplasms.
BACKGROUND
Although fine-needle aspiration (FNA) is the most sensitive method for the detection of thyroid carcinoma, it cannot provide a definitive diagnosis of malignancy in 60% of the patients operated on for suspicious lesions. Recently, human telomerase reverse transcriptase (hTERT) has been found to be a diagnostic marker of malignancy. We therefore sought to determine whether hTERT gene expression could serve as an adjunct to FNA in the differential diagnosis of thyroid nodules.


METHODS
Twenty-four FNA samples from thyroid nodules that were suspected of malignancy were collected. RNA was extracted, and hTERT gene expression was examined by RT-PCR. Cytologic and histologic examinations were also performed.


RESULTS
Two of three follicular, three of three Hürthle cell, and eight of eight papillary thyroid carcinomas had corresponding FNA samples that were positive for hTERT. One of two Hürthle cell adenomas was hTERT positive. FNA samples from three follicular adenomas and five hyperplastic nodules were negative for hTERT. Positive and negative predictive values were 93% and 90%, respectively.


CONCLUSIONS
The detection of hTERT gene expression in thyroid FNA samples holds promise as a diagnostic marker in the distinction of benign from malignant thyroid lesions. Its application could alter the surgical management of these patients.
Zeiger
M A
MA
Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21287-8611, USA.
Smallridge
R C
RC
Clark
D P
DP
Liang
C K
CK
Carty
S E
SE
Watson
C G
CG
Udelsman
R
R
Saji
M
M
D018263:Adenocarcinoma, Follicular / Q000235:genetics / Q000473:pathology; D001707:Biopsy, Needle; D002291:Carcinoma, Papillary / Q000235:genetics* / Q000473:pathology*; D004268:DNA-Binding Proteins; D015971:Gene Expression Regulation, Enzymologic; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D011237:Predictive Value of Tests; D012313:RNA; D012333:RNA, Messenger / Q000032:analysis; D012334:RNA, Neoplasm / Q000032:analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D019098:Telomerase / Q000235:genetics*; D013964:Thyroid Neoplasms / Q000235:genetics* / Q000473:pathology*
D004268:DNA-Binding Proteins; D012333:RNA, Messenger; D012334:RNA, Neoplasm; C422952:telomerase RNA; D012313:RNA; D019098:Telomerase