HTERT GENE EXPRESSION IN SUSPICIOUS THYROID FNA SAMPLES

描述：(改编自调查人员的摘要)尽管针头很细 摘要甲状腺结节抽吸(FNA)是最敏感、最特异的方法。 对于恶性肿瘤的检测，大多数需要手术的患者 对恶性肿瘤的怀疑只有不确定或可疑的诊断 细胞学上。因为良性和恶性之间的区别不能 在这些病例的术前或术中，良性病变的患者可能 接受比必要更广泛的手术，反之，患有 癌症，不够充分的初期手术。 尽管在甲状腺肿瘤中已有各种基因改变的记录 并被认为与肿瘤的发生和恶性有关 进展，没有特定的改变可以可靠地区分良性和 恶性病变。与此相关的是端粒酶，已有报道。 在几乎所有的恶性肿瘤中都被重新激活，而它的表达是 几乎在所有正常细胞中都被抑制。最近，该公司的催化成分 端粒酶，人端粒酶逆转录酶(HTERT)，已被克隆和 序列。她开发了一种检测hTERT基因表达的方法 逆转录聚合酶链式反应(RT-PCR)检测其 在甲状腺结节和FNAs中均有表达。她发现它的表达方式 与端粒酶活性有关，hTERT的检测是一种 比端粒酶活性检测更敏感。她还发现了基因 13/14例恶性肿瘤患者不明原因的FNA阳性表达 良性肿瘤中9/10为阴性。端粒酶逆转录酶基因的检测 因此，在甲状腺FNA样本中的表达作为一种 甲状腺恶性肿瘤的诊断标记物。它在可疑甲状腺疾病中的应用 FNA样本可以极大地改变患者的手术治疗 这些损伤。正因为如此，她建议进行一种盲目的预测 多机构研究，检测240份可疑甲状腺组织的FNA样本 检测病变组织中hTERT的表达以评估其敏感性 以及为了确定它是否可以作为一种准确的 恶性肿瘤标志物在可疑甲状腺鉴别诊断中的应用 结节。

DESCRIPTION: (adapted from the investigator's abstract) Although fine needle aspiration (FNA) of thyroid nodules is the most sensitive and specific method for the detection of malignancy, a majority of patients who require surgery for a suspicion of malignancy have only an indeterminate or suspicious diagnosis cytologically. Because the distinction between benign and malignant cannot be made pre- or intra-operatively in these cases, patients with benign lesions may undergo more extensive surgery than necessary and conversely, patients with carcinoma, less than adequate initial surgery. Although various genetic alterations have been documented in thyroid neoplasms and are believed to be associated with their tumorigenesis and malignant progression, no specific alteration can reliably distinguish benign from malignant lesions. Relevant to this, the enzyme telomerase, has been reported to be reactivated in almost all malignant neoplasms, whereas its expression is repressed in almost all normal cells. Recently, the catalytic component of telomerase, human telomerase reverse transcriptase (hTERT), has been cloned and sequence. She has developed a detection method for hTERT gene expression using reverse transcriptase polymerase chain reaction (RT-PCR) and examined its expression in both thyroid nodules and FNAs. She has found that its expression correlates with telomerase enzyme activity and that the detection of hTERT is a more sensitive assay than telomerase activity. She also has found gene expression to be positive in indeterminate FNA samples from 13/14 malignant tumors, and negative in 9/10 benign tumors. The detection of hTERT gene expression in thyroid FNA samples therefore holds tremendouse pomise as a diagnostic marker of thyroid malignancy. Its application to suspicious thyroid FNA samples could dramatically alter the surgical management of patients with these lesions. Because of this, she proposes to conduct a blinded prospective multi-institutional study, examining 240 FNA samples from suspicious thyroid lesions for hTERT expression in order to estimate its sensitivity and specificity and in order to determine whether it can serve as an accurate marker of malignancy in the differential diagnosis of the suspicious thyroid nodule.