<i>BRAF</i>V600 co-testing in thyroid FNA cytology: short-term experience in a large cancer centre in the UK

Poller, David; Glaysher, Sharon; Agrawal, Avi; Caldera, S.; Kim, Dae; Yiangou, C.

doi:10.1136/jclinpath-2014-202348

Cited by 19 publications

(11 citation statements)

References 27 publications

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“…Two recent studies evaluated the role of BRAF testing in thyroid cytology. Poller et al [41] demonstrated that BRAF cotesting of thyroid aspirates classified as SFM identified a subset of tumors (40%) that were BRAF -mutated. Potentially, these tumors would be managed as malignant (total thyroidectomy), avoiding the costs and risks related to a secondary neck surgery (completion thyroidectomy).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Indeterminate Thyroid Cytology by Second-Opinion Diagnosis or Repeat Fine-Needle Aspiration: Which Is the Best Approach?

Gerhard

Boerner²

2015

Acta Cytologica

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Objective: This study investigated a published series evaluating the role of second-opinion diagnosis (SOD) or repeat fine-needle aspiration cytology (RFNA) for indeterminate thyroid aspirates. Study Design: Twenty-three studies were selected and the following parameters were analyzed: disagreement between SOD or RFNA and the original diagnosis (OD), reclassification of OD according to the Bethesda system for reporting thyroid cytopathology, the rate of definitive diagnosis and the diagnostic performance of SOD and RFNA. Results: 7,154 thyroid FNAs were retrieved from 9 studies that investigated the role of SOD, including 1,048 (14.6%) cases originally reported as indeterminate. The 14 studies that analyzed the role of thyroid RFNA comprised 67,581 FNAs and included 7,246 (10.7%) indeterminate cases. A definitive diagnosis was achieved by SOD in 450 cases (42.9%) and RFNA in 1,645 cases (57.2%, p = 0.0001). Based on cases with histological follow-up, SOD demonstrated significantly higher rates of positive predictive value and accuracy than RFNA (55.8 vs. 37.7%, p = 0.0001; 67.4 vs. 56.0%, p = 0.0034, respectively). Conclusions: Both SOD and RFNA demonstrated an improvement in the diagnosis of initially indeterminate thyroid FNAs. RFNA achieved a definitive diagnosis for the majority of indeterminate cases. Regarding histological follow-up, SOD was shown to be more accurate than RFNA.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Indeterminate Thyroid Cytology by Second-Opinion Diagnosis or Repeat Fine-Needle Aspiration: Which Is the Best Approach?

Gerhard

Boerner²

2015

Acta Cytologica

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“…14 studies were conducted in the USA [69]. All studies were conducted between 2004 and 2014 and the number of patients ranged from 10 to 6,402 with a mean age of 47.5 (Tables 1 and 2).…”

Section: Study and Patient Characteristicsmentioning

confidence: 99%

Diagnostic value of fine needle aspiration BRAFV600E mutation analysis in papillary thyroid cancer: a systematic review and meta-analysis

et al. 2015

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Fine needle aspiration (FNA) with cytologic analysis is an initial step in diagnosing thyroid nodules that are suspicious for cancer. We systematically reviewed the test accuracy of B-type Raf kinase (BRAF(V600E)) gene mutation analysis plus conventional FNA in the diagnosis of papillary thyroid cancer. We identified studies reporting BRAF(V600E) mutation analysis after FNA for evaluation of thyroid nodules through searching MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials, scanning reference lists of relevant studies, and contacting experts. Two independent reviewers screened literature results, abstracted data, and appraised study quality. When appropriate, bivariate and univariate random-effects meta-analyses of sensitivity and specificity were considered for all outcomes. Forty-seven studies met our inclusion criteria after screening 1560 citations and 169 full-text articles. The included studies enrolled approximately 16170 patients with 9924 FNA samples evaluated for BRAF(V600E) mutation. Univariate pooled sensitivity was 69% (95% confidence interval, 61%-76%) for papillary thyroid cancer. For thyroid nodules that were diagnosed cytologically as suspicious for papillary thyroid cancer, univariate pooled sensitivity using FNA and BRAF(V600E) results was 52% (95% confidence interval, 39%-64%). Despite its high specificity, our meta-analysis shows that BRAF(V600E) mutation analysis has a low sensitivity in diagnosing papillary thyroid cancer in thyroid nodules. The feasibility of this test as a single molecular tool is not well established, which indicates the need for well-designed prospective clinical studies.

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“…4 The use of intraoperative FS has long been debated secondary to concerns about increased cost and operative time without a true consensus. 13,14 In 24 This is a challenging and controversial diagnosis as these tumors have no invasion and the diagnosis of cancer rests exclusively on finding the characteristic nuclei, assessment of which in many cases is subjective, leading to consistently high interobserver variability. In addition, dependence on FNA interpretation to guide surgical management without IFS was investigated.…”

Section: Introductionmentioning

confidence: 99%

Utility of intraoperative frozen sections for thyroid nodules with prior fine needle aspiration cytology diagnosis

Roychoudhury

Souza

Gimenez

et al. 2017

Diagnostic Cytopathology

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Our study does not support the use of IFS for nodules with prior FNA interpretation of Bethesda II, III, IV and VI as management was not significantly changed. IFS is of value for nodules with prior FNA diagnosis of Bethesda I for interpretation of nodule, and Bethesda V for planning surgery. A confirmatory diagnosis could not be rendered at IFS for lesions with follicular architecture, which comprised most of the cases in Bethesda III and IV.

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BRAFV600 co-testing in thyroid FNA cytology: short-term experience in a large cancer centre in the UK

Cited by 19 publications

References 27 publications

Evaluation of Indeterminate Thyroid Cytology by Second-Opinion Diagnosis or Repeat Fine-Needle Aspiration: Which Is the Best Approach?

Evaluation of Indeterminate Thyroid Cytology by Second-Opinion Diagnosis or Repeat Fine-Needle Aspiration: Which Is the Best Approach?

Diagnostic value of fine needle aspiration BRAFV600E mutation analysis in papillary thyroid cancer: a systematic review and meta-analysis

Utility of intraoperative frozen sections for thyroid nodules with prior fine needle aspiration cytology diagnosis

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