Diagnostic discriminants of thyroid cancer

Evans, Douglas M.

doi:10.1016/0002-9610(87)90157-7

Cited by 6 publications

(2 citation statements)

References 9 publications

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“…Clinical criteria, ultrasonography as well as scintigraphy, should always be considered in the management of such nodules, but they are not accurate enough in ruling-in or ruling-out thyroid malignancies, because their unfavorable likelihood ratios [ 28 , 98 , 99 ]. Founded on these criteria, many unnecessary surgical procedures are still performed to remove benign lesions [ 29 , 100 – 103 ]. The real innovation in this field, however, is the availability of new techniques, designed to identify specific genetic and epigenetic markers of thyroid malignancy.…”

Section: Discussionmentioning

confidence: 99%

Comparative analysis of diagnostic performance, feasibility and cost of different test-methods for thyroid nodules with indeterminate cytology

et al. 2017

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Since it is impossible to recognize malignancy at fine needle aspiration (FNA) cytology in indeterminate thyroid nodules, surgery is recommended for all of them. However, cancer rate at final histology is <30%. Many different test-methods have been proposed to increase diagnostic accuracy in such lesions, including Galectin-3-ICC (GAL-3-ICC), BRAF mutation analysis (BRAF), Gene Expression Classifier (GEC) alone and GEC+BRAF, mutation/fusion (M/F) panel, alone, M/F panel+miRNA GEC, and M/F panel by next generation sequencing (NGS), FDG-PET/CT, MIBI-Scan and TSHR mRNA blood assay.We performed systematic reviews and meta-analyses to compare their features, feasibility, diagnostic performance and cost. GEC, GEC+BRAF, M/F panel+miRNA GEC and M/F panel by NGS were the best in ruling-out malignancy (sensitivity = 90%, 89%, 89% and 90% respectively). BRAF and M/F panel alone and by NGS were the best in ruling-in malignancy (specificity = 100%, 93% and 93%). The M/F by NGS showed the highest accuracy (92%) and BRAF the highest diagnostic odds ratio (DOR) (247). GAL-3-ICC performed well as rule-out (sensitivity = 83%) and rule-in test (specificity = 85%), with good accuracy (84%) and high DOR (27) and is one of the cheapest (113 USD) and easiest one to be performed in different clinical settings.In conclusion, the more accurate molecular-based test-methods are still expensive and restricted to few, highly specialized and centralized laboratories. GAL-3-ICC, although limited by some false negatives, represents the most suitable screening test-method to be applied on a large-scale basis in the diagnostic algorithm of indeterminate thyroid lesions.

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Section: Discussionmentioning

confidence: 99%

Comparative analysis of diagnostic performance, feasibility and cost of different test-methods for thyroid nodules with indeterminate cytology

et al. 2017

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“…Approximately 4% of the general population and 10-12% of routine autopsy specimens have solitary thyroid nodules [7-111. Werk et al found that of 153 patients with thyroid nodules, black females between 20 and 40 years of age had a malignancy rate of 15.4%, which was second only to the 25% malignancy rate in white women under age 20 years [12][13][14][15]. Because the asymptomatic thyroid nodule is as likely to be malignant in black patients as in the general population, these nodules must be diligently worked up in black patients.…”

Section: Discussionmentioning

confidence: 99%

Carcinoma of the thyroid in black patients

Brooks¹,

Rogers²,

Ransome³

et al. 1992

Journal of Surgical Oncology

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In the period from January 1, 1976 to December 31, 1988, we reviewed the charts of 33 patients treated for carcinoma of the thyroid at Howard University Hospital. The three non-black patients (two Whites and one Pakistani) were excluded from the study. There were 19 females and 11 males. Of the 30 cases elevated, 10 were papillary, 7 were follicular variant of papillary, 8 were follicular, 3 were undifferentiated (anaplastic), and 2 were medullary. Ten patients had either distant metastasis (Hoffman, South Med J 80:741, 1987) or locally advanced disease in the neck (Woolner et al., Am J Surg 102:354, 1961.) at the time of diagnosis. The treatment of these lesions depended on, among other variables, the cell type, the extent of the lesion, and the personal preference of the attending surgeon. Carcinoma of the thyroid remains an uncommon lesion in Black patients. Because of its rarity, the diagnosis may often be delayed and, as a result, patients may first come to attention with a more advanced stage of this disease. To prevent this occurrence, a high index of suspicion must be maintained for all thyroid nodules, and appropriate diagnostic steps taken. Diagnostic and treatment options are discussed.

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Thyroid

Maisey¹

1998

Clinical Nuclear Medicine

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Diagnostic discriminants of thyroid cancer

Cited by 6 publications

References 9 publications

Comparative analysis of diagnostic performance, feasibility and cost of different test-methods for thyroid nodules with indeterminate cytology

Comparative analysis of diagnostic performance, feasibility and cost of different test-methods for thyroid nodules with indeterminate cytology

Carcinoma of the thyroid in black patients

Thyroid

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