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

Area of Science:

• Oncology
• Molecular Diagnostics
• Endocrinology

Background:

• Fine-needle aspiration (FNA) has limitations in definitively diagnosing thyroid carcinoma.
• A significant percentage of patients with suspicious thyroid lesions require surgery due to inconclusive FNA results.
• Human telomerase reverse transcriptase (hTERT) has emerged as a potential malignancy marker.

Purpose of the Study:

• To evaluate the utility of hTERT gene expression as an adjunct diagnostic marker in thyroid fine-needle aspiration (FNA) samples.
• To determine if hTERT expression can improve the differential diagnosis of thyroid nodules.
• To assess the potential impact of hTERT detection on surgical management decisions.

Main Methods:

• Collected 24 FNA samples from thyroid nodules with suspected malignancy.
• Extracted RNA and analyzed hTERT gene expression using reverse transcription-polymerase chain reaction (RT-PCR).
• Performed cytologic and histologic examinations for comparison.

Main Results:

• hTERT was detected in FNA samples of most thyroid carcinomas (follicular, Hürthle cell, papillary).
• One Hürthle cell adenoma was positive for hTERT; follicular adenomas and hyperplastic nodules were negative.
• The positive and negative predictive values for hTERT detection were 93% and 90%, respectively.

Conclusions:

• hTERT gene expression in thyroid FNA samples is a promising marker for differentiating benign from malignant thyroid lesions.
• The application of hTERT detection could significantly alter the surgical management of patients with thyroid nodules.
• This molecular marker offers improved diagnostic accuracy for suspicious thyroid findings.