Human telomerase reverse transcriptase (hTERT) gene expression in FNA samples from thyroid neoplasms

Background, Although fine-needle aspiration (FNA) is the most sensitive met hod for the detection of thyroid carcinoma, it cannot provide a definitive diagnosis of malignancy in 60% of the patients operated on for suspicious l esions. Recently, human telomerase reverse transcriptase (hTERT) has been f ound to be a diagnostic marker of malignancy. Wie therefore sought to deter mine 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 o f malignancy were collected. RNA was extracted, and hTERT gene expression w as examined by RT-PCR Cytologic and histologic examinations were also perfo rmed. Results, Two of three follicular, three of three Hurthle cell, and eight of eight papillary thyroid carcinomas had corresponding FNA samples that were positive for hTERT. One of two Hurthle cell adenomas was hTERT positive. F NA samples from three follicular adenomas and five hyperplastic nodules wer e 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 mali gnant thyroid lesions. Its application could alter the surgical management of these patients.