Document Detail

HMGA2 gene expression analysis performed on cytologic smears to distinguish benign from malignant thyroid nodules.
MedLine Citation:
PMID:  20597139     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Up to 80% of thyroid nodules with an indeterminate diagnosis on fine-needle aspiration (FNA) (eg, "suspicious for follicular neoplasm") prove to be benign at the time of surgical resection. Ancillary tests in current use are limited in their ability to improve the preoperative detection of malignant follicular thyroid nodules. Studies using paraffin-embedded tissue have indicated that high mobility group AT-hook 2 (HMGA2) overexpression is present in a high percentage of malignant thyroid neoplasms but not in benign thyroid neoplasms. In the current study, the ability of HMGA2 overexpression analysis to preoperatively distinguish benign from malignant thyroid nodules by reverse transcriptase-polymerase chain reaction (RT-PCR) on suspicious cytologic smears was evaluated.
METHODS: Patients who underwent thyroid FNA and subsequent thyroid resection from 2001 through 2007 were identified. A subset of these patients who had a cytologic diagnosis of "suspicious" underwent HMGA2 expression analysis. HMGA2 expression was detected on cells scraped from cytologic smears with 1-step, real-time quantitative RT-PCR.
RESULTS: Of the 125 cases identified, RNA extraction and HMGA2 analysis were successful in 115 cases. With an HMGA2 overexpression change of 5.9-fold or greater compared with a thyroid tumor cell line as a positive cutoff, the test was found to have the following overall performance for detecting malignant nodules: sensitivity of 71%, specificity of 97%, positive predictive value of 94%, and negative predictive value of 84%. HMGA2 overexpression was found to have low sensitivity for detecting Hurthle cell carcinoma (33%).
CONCLUSIONS: HMGA2 mRNA expression analysis can be performed on cytologic smears and demonstrates a high specificity and positive predictive value and relatively high sensitivity and negative predictive value for detecting malignancy in "suspicious" thyroid aspirate specimens.
Paul J Lappinga; N Sertac Kip; Long Jin; Ricardo V Lloyd; Michael R Henry; Jun Zhang; Aziza Nassar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cancer cytopathology     Volume:  118     ISSN:  1934-662X     ISO Abbreviation:  Cancer Cytopathol     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-11-29     Completed Date:  2010-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101499453     Medline TA:  Cancer Cytopathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  287-97     Citation Subset:  IM    
Copyright Information:
© 2010 American Cancer Society.
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
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MeSH Terms
Adenocarcinoma, Follicular / diagnosis,  genetics
Adenoma, Oxyphilic / diagnosis,  genetics
Aged, 80 and over
Biopsy, Fine-Needle
Cytodiagnosis / methods
Diagnosis, Differential
Gene Expression Regulation, Neoplastic*
Goiter / diagnosis,  genetics
HMGA2 Protein / genetics*
Middle Aged
RNA, Messenger / genetics,  metabolism
Reproducibility of Results
Reverse Transcriptase Polymerase Chain Reaction
Sensitivity and Specificity
Thyroid Gland / metabolism*,  pathology
Thyroid Nodule / diagnosis,  genetics*,  pathology
Young Adult
Reg. No./Substance:
0/HMGA2 Protein; 0/RNA, Messenger

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