Preoperative diagnosis of suspicious parathyroid adenomas by RT-PCR using mRNA extracted from leftover cells in a needle used for ultrasonically guided fine needle aspiration cytology.
OBJECTIVE
To determine the usefulness of reverse transcriptase-polymerase chain reaction (RT-PCR) detection of parathormone (PTH) gene mRNA in needle aspirates to confirm the parathyroid nature of suspicious cervical lesions in patients with hyperparathyroidism.


METHODS
Ultrasound-guided fine needle aspiration cytology (FNAC) was performed on 12 patients with suspected parathyroid adenomas. The aspirates were subjected to cytologic and chromogranin A examination. Messenger RNA was isolated from left-over cells within the needle, and RT-PCR was used to amplify mRNA encoding PTH.


RESULTS
The 12 aspirates were positive by PTH RT-PCR, and molecular diagnosis was confirmed by histologic examination. The lower sensitivity of cytologic and immunocytochemical methods was demonstrated, respectively, by 67% and 50% of positive results. Sensitivity assays demonstrated that with our system, PTH RT-PCR products are obtained from as few as 10 pg of parathyroid mRNA.


CONCLUSIONS
The present study showed that RT-PCR-based analysis of PTH gene transcripts in aspirates, obtained by US-guided FNAC of cervical lesions suspicious for parathyroid adenoma, is a feasible, sensitive and specific method for preoperative diagnosis of parathyroid adenomas.
Cavaco
Branca M
BM
Center for the Investigation of Molecular Pathobiology, Departments of Imagiology and Endocrinology, Cytology Laboratory, Francisco Gentil Portuguese Oncology Institute, Lisbon, Portugal.
Torrinha
Fernando
F
Mendonça
Evelina
E
Pratas
Sónia
S
Boavida
José
J
Sobrinho
Luís G
LG
Leite
Valeriano
V
D000236:Adenoma / Q000175:diagnosis* / Q000473:pathology; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D053379:Chromogranin A; D002864:Chromogranins / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D025202:Molecular Diagnostic Techniques; D010281:Parathyroid Hormone / Q000235:genetics*; D010282:Parathyroid Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D012333:RNA, Messenger / Q000032:analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D014463:Ultrasonography
D053379:Chromogranin A; D002864:Chromogranins; D010281:Parathyroid Hormone; D012333:RNA, Messenger