Does telomerase activity add to the value of fine needle aspirations in evaluating thyroid nodules?

Sebesta, James A.; Brown, Tommy A.; Williard, William; DeHart, Mary; Aldous, Wade K.; Kavolius, Jeffery; Azarow, Kenneth S.

doi:10.1016/s0002-9610(01)00605-5

Cited by 24 publications

(15 citation statements)

References 9 publications

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“…In studies measuring telomerase activity using fi ne needle aspiration specimen, telomerase activity was found in 92% of breast cancers and 38-60% of thyroid cancers [19,20].…”

Section: Discussionmentioning

confidence: 99%

“…Given the improved sensitivity of assays for measuring telomerase activity, telomerase activity can now be detected in almost any type of clinical specimen including urine, bladder washes, oral rinses, pancreatic duct brushings, colonic luminal washes, fi ne needle aspiration specimens and cerebrospinal fl uid [16][17][18][19][20]. In recent studies, telomerase activity was detected in the circulating epithelial cells of peripheral blood in breast and bladder cancer patients and mononuclear cells of peripheral blood in head and neck squamous cell carcinoma (HNSCC) patients, and human telomerase reverse transcriptase messenger RNA was also detected in the circulating epithelial cells of peripheral blood in hepatic cancer patients [21][22][23][24][25][26].…”

Section: Introductionmentioning

confidence: 99%

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Change of telomerase activity in peripheral whole blood of head and neck squamous cell carcinoma patients before and after surgery: a pilot study

et al. 2011

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BACKGROUND The purpose of this study was to evaluate telomerase activity in peripheral whole blood from head and neck squamous cell carcinoma (HNSCC) patients as a biomarker for diagnosis of HNSCC or detection of recurrence during follow-up. MATERIALS AND METHODS Telomerase activity was measured from peripheral whole blood extracts by telomerase repeat amplification protocol (TRAP) in HNSCC patients before and after surgery and in a control group. Sixty-two HNSCC patients and 42 control subjects were included. RESULTS Telomerase activity was found in 41 out of 62 (66.1%) HNSCC patients before surgery and in 8 out of 42 (19.0%) controls (p<0.001). Among 41 HNSCC patients who showed positive telomerase activity before surgery, 32 (78.1%) showed a conversion of telomerase activity to negative after surgery. In follow-up, 6 out of 8 (75%) showed conversion of telomerase activity from negative to positive after recurrence. Telomerase activity was changed to negative in 4 out of 6 (66%) recurred patients with positive telomerase activity after second surgery. CONCLUSION The telomerase activity in peripheral whole blood extracts of HNSCC patients might be a useful biomarker for detecting recurrence after treatment. Further study with larger sample size using a more sensitive detection method of telomerase activity is necessary to verify these results.

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“…In studies measuring telomerase activity using fi ne needle aspiration specimen, telomerase activity was found in 92% of breast cancers and 38-60% of thyroid cancers [19,20].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Change of telomerase activity in peripheral whole blood of head and neck squamous cell carcinoma patients before and after surgery: a pilot study

et al. 2011

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“…Furthermore, several studies have demonstrated that lymphocyte contamination (known to exhibit high telomerase activity) can yield false-positive results due to their inherently high hTERT activity [30]. In addition, two studies have failed to show any advantage of using hTERT expression as an additional marker of thyroid cancer over using FNAC analysis alone [34,35]. It appears, therefore, that telomerase detection may not represent a likely future marker of thyroid malignancy.…”

Section: Telomerasementioning

confidence: 99%

Novel molecular markers in well-differentiated thyroid cancers

McCabe

2006

Expert Review of Endocrinology & Metabolism

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Conventional cytopathology is an excellent tool for distinguishing benign from malignant thyroid nodules with high sensitivity and specificity. However, significant numbers of cases are indeterminate, resulting in many ultimately unnecessary diagnostic thyroidectomies. Numerous molecular markers have been studied in an attempt to improve the diagnostic accuracy of thyroid fine-needle aspiration cytology. Several markers, such as galectin-3 and thyroid peroxidase, have been extensively assessed and shown not only to differentiate malignant tumors from benign thyroid lesions with high sensitivity and specificity, but also to identify tumors associated with poor outcome. More recently, four other genes (PTTG, PBF, BRAF and MUC1) have been identified that show real promise as potential molecular markers in thyroid cancer, offering discrimination between tumor subtypes and providing valuable prognostic information. However, larger, well-controlled studies are needed before their introduction into routine clinical practice. The search for molecular markers represents one of the most exciting areas in translational thyroid cancer research. We are optimistic that molecular markers will be used in the near future as adjuncts to conventional histological techniques to improve diagnostic accuracy of fine-needle aspiration cytology for thyroid lesions, particularly those that are cytologically indeterminate. Expert Rev. Endocrinol. Metab. 1(5), 685-693 (2006) Search for molecular markersThyroid cancer is the most common endocrine cancer, accounting for approximately 90% of all endocrine tumors, and its incidence is increasing worldwide [1][2][3]. Despite advances in treatment, recurrence still occurs in approximately 20% of cases, most commonly as local nodal metastases and less often as distant hematogenous metastases, leading to substantial morbidity and premature mortality [4].Thyroid nodules are very common with approximately 5-10% of the population having palpable thyroid nodules [5]. Differentiation between benign and malignant nodules represents an important clinical diagnostic challenge. Fine-needle aspiration cytology (FNAC) is widely established as a reliable and effective procedure in the clinical management of thyroid nodules [6]. Despite high sensitivity and specificity, significant numbers of cases (10-25%) are indeterminate, usually failing to differentiate between benign follicular lesions and follicular thyroid cancers [7,8]. These cases require surgery in the form of hemi-thyroidectomy to achieve diagnosis. Only 20-25% of these nodules are ultimately found to be malignant; therefore, 75-80% of patients undergo an unnecessary operation [1,9]. In addition, currently available standard histopathology and cytology techniques do not provide prognostic information regarding prediction of future recurrences. Risk assessment based upon clinical factors, such as age and gender, is relied upon to assist in differentiating high-risk patients.The population undergoing surveillance for recurrent thyroid cancer is many t...

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“…The measurement of telomerase activity proved to be the most specific for the detection of thyroid carcinoma in frozen tissue samples as a single analyte, but diagnostic accuracy was increased by the combination of telomerase and CD44 analyses (36). On the other hand, Sebasta et al (37) found that telomerase assays did not add any additional information to FNA alone (37). They performed telomeric repeat amplification protocol assays on FNA specimens of thyroid nodules in 19 patients.…”

Section: Introductionmentioning

confidence: 99%

“…Telomerase activity was found in 3 of 5 malignant (60%) and 9 of 14 benign (64%): sensitivity was 60%, specificity was 36%. The authors concluded that inflammatory changes associated with benign and malignant lesions can possess telomerase activity independent of the malignant state (37).…”

Section: Introductionmentioning

confidence: 99%

Polymerase Chain Reaction in the Detection of Tumor Cells: New Approaches in Diagnosis and Follow-Up of Patients with Thyroid Cancer

Bojunga

Kusterer

Schumm–Draeger

et al. 2002

Thyroid

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Thyroid cancers are the most common endocrine malignancies and are being diagnosed with increasing frequency. In addition to other measures, diagnosis is based on fine-needle aspiration cytology examination. Recently, new assays using reverse transcription-polymerase chain reaction (PCR) are being tested to improve sensitivity and specificity of primary diagnosis and detection of recurrent thyroid cancer. In the preoperative diagnosis of thyroid cancer, several tissue- and/or tumor-specific mRNA have been described and in several cases, a higher sensitivity and specificity could be achieved using molecular techniques compared to conventional methods. In the postoperative follow-up of patients with thyroid cancer, conflicting data have been published and the use of PCR techniques revealed several problems of the molecular approach, which are based on some technical as well as biologic limitations. Despite these problems, which are discussed in detail in this review, molecular techniques may nevertheless improve the sensitivity and accuracy of fine-needle aspiration of thyroid nodules, fine-needle aspiration of metastases, and detection of recurrent disease in peripheral blood samples.

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Does telomerase activity add to the value of fine needle aspirations in evaluating thyroid nodules?

Cited by 24 publications

References 9 publications

Change of telomerase activity in peripheral whole blood of head and neck squamous cell carcinoma patients before and after surgery: a pilot study

Change of telomerase activity in peripheral whole blood of head and neck squamous cell carcinoma patients before and after surgery: a pilot study

Novel molecular markers in well-differentiated thyroid cancers

Polymerase Chain Reaction in the Detection of Tumor Cells: New Approaches in Diagnosis and Follow-Up of Patients with Thyroid Cancer

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