Identifying a tumor marker that can help distinguish benign from malignant thyroid tumors is crucial, because up to 30% of thyroid fine-needle aspirations (FNA) are diagnosed as 'suspicious' or follicular neoplasm for malignancy. Recently, the detection of human telomerase reverse transcriptase (hTERT) gene expression in thyroid FNA samples has been identified as a promising diagnostic marker in distinguishing benign and malignant thyroid tumors. Twenty-seven FNA samples from thyroid tumors that were suspected to be malignant were collected preoperatively, hTERT gene expression was examined by reverse transcriptase-polymerase chain reaction (RT-PCR), and the cytological and histological results were compared. The results demonstrated that 13 (92.8%) of 14 thyroid carcinomas, including eight of eight papillary, three of four follicular, and two of two Hürthle cell thyroid carcinomas have corresponding FNA samples that were positive for hTERT. Meanwhile, eight (61.5%) of 13 benign thyroid nodules, including three of six nodular goiter, two of two Graves' disease, two of two Hürthle cell adenomas, and one of three follicular adenomas were positive for hTERT. In conclusion, hTERT was more prevalent in malignant thyroid FNA samples than in the benign thyroid FNA samples. Notably, the extent of the differences in hTERT expression between benign and malignant follicular thyroid tumors require further investigation. Moreover, further information including semi-quantitative real-time RT-PCR, is required to verify whether hTERT mRNA expression could serve as an adjunctive molecular marker for the preoperative diagnosis of thyroid malignancies.
Copyright 2002 Elsevier Science Ireland Ltd.