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

Background: Telomerase replaces DNA sequences that are lost with cell division. Increased activity has been documented in malignant cells. Fine needle aspiration (FNA) has a 90% sensitivity for diagnosis of papillary carcinomas, but a specificity of 52%. This often leads to unnecessary surgery. Methods: Telomeric repeat amplification protocol assays were performed on FNA specimens of thyroid nodules in 19 patients. These results were compared with the surgical pathology using chi-square analysis. Results: There were 5 malignant and 14 benign nodules. Telomerase activity was found in 3 of 5 malignant (60%) and 9 of 14 benign (64%): sensitivity was 60%, specificity was 36%. Conclusion: Telomerase assays did not add any additional information to FNA alone. Inflammatory changes associated with benign and malignant lesions can possess telomerase activity independent of the malignant stale. (C) 2001 Excerpta Medica, Inc. All rights reserved.