Risk stratification of indeterminate thyroid nodules by novel multigene testing: a study of Asians with a high risk of malignancy

Hu, Chunfang; Jing, Weiwei; Chang, Qing; Zhang, Zhihui; Liu, Zhenrong; Cao, Jian; Zhao, Lidan; Sun, Yue; Zhao, Huan; Xiao, Ting; H, Guo

doi:10.1002/1878-0261.13205

Cited by 7 publications

(9 citation statements)

References 42 publications

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“…For the DNA-RNA classifier, the sensitivity, specificity, PPV, and NPV were 88.4%, 53.3%, 84.4% and 61.5%, respectively. This study showed that the PPV for the DNA-RNA and the RNA classifier were higher (84.4% and 81.6% vs. 37.4% and 63.3%) and the NPV were lower (61.5% and 66.7% vs. 94.3% and 90.9%) than those of Afirma GEC and ThyroSeq v3 in their cohort [ 98 ]. The result of this study is showing that in an environment with high ROM among ITNs, like these Asian countries, the molecular testing may be more useful as a rule in test rather than a rule out test.…”

Section: Discussionmentioning

confidence: 99%

Molecular Testing for Thyroid Nodules: The Experience at McGill University Teaching Hospitals in Canada

Rajab

Payne

Forest

et al. 2022

Cancers

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In the past few decades, molecular characterization of thyroid cancer has made significant progress and is able to identify thyroid-cancer-related molecular markers that can then be applied clinically for improved decision making. The aim of this review is to provide a general overview about the molecular markers (mutations and alterations) of thyroid cancers, present several molecular tests, and discuss the clinical applications of identifying these markers supported by the clinical experience of several high-volume thyroid cancer specialists at the McGill university hospitals in Montreal, Canada. Our group experience showed that molecular testing can reclassify more than half of the patients with indeterminate thyroid nodules (Bethesda III and IV) into benign and spare these patients from unnecessary diagnostic surgery. Furthermore, it can help optimize the initial management in thyroid cancers with no evidence of high risk of recurrence of disease preoperatively. While routine molecular testing is not firmly established for thyroid FNA specimens that are suspicious or positive for malignancy (Bethesda V and VI), knowledge of a thyroid nodule’s molecular risk group profile in such cases, together with its clinical and radiologic features, can help select the optimal surgical options (lobectomy versus upfront total thyroidectomy and central neck dissection), as demonstrated by our studies.

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Section: Discussionmentioning

confidence: 99%

Molecular Testing for Thyroid Nodules: The Experience at McGill University Teaching Hospitals in Canada

Rajab

Payne

Forest

et al. 2022

Cancers

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“…Another explanation is that the rate of malignancy of ITNs in China may be underestimated. A study that recruited 140 samples in China showed that the malignant rate was 74.1% for resected ITNs [60]. Another multicenter study in Israel included 810 patients and indicated that the malignancy rates were higher than those reported earlier.…”

Section: Discussionmentioning

confidence: 90%

Risk assessment of cytologically indeterminate thyroid nodules with integrated molecular testing and repeat biopsy: a surgical decision-oriented tool

et al. 2023

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Background The preoperative diagnosis of cytologically indeterminate thyroid nodules (ITNs) is very challenging. In this study, we aim to provide an integrated risk assessment for thyroid nodules with indeterminate cytology to guide surgical decision-making, which includes results of blood tests, molecular tests, and repeat fine-needle aspiration biopsy (FNAB). Methods The study retrospectively included 265 ITNs between June 2019 and April 2022. According to our integrated risk assessment process that starts with blood testing, followed by supplementary DNA mutation detection on the first FNAB, and finally repeat FNAB, we divided the ITNs into high-risk and low-risk groups. Performance was evaluated with sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), area under the receiver operating characteristic curve (AUC), and the consistency between the risk evaluation and histological results. Results Of the 265 ITNs, 87 were included in the risk assessment process. The risk assessment had a sensitivity of 84.1%, specificity of 83.3%, PPV of 95.1%, NPV of 57.7%, and AUC of 0.837. The nodules with consistent results between the risk groups and histological outcomes, which included malignant cases in the high-risk group and benign cases in the low-risk group, accounted for 83.9% of all risk-assessed nodules. Conclusions These data suggest that the integrated risk assessment might provide proper information for surgical decision-making in patients with ITNs.

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“…A study that recruited 140 samples in China showed that the malignant rate was 74.1% for resected ITNs. (42) Another multicenter study in Israel included 810 patients and indicated that the malignancy rates were higher than those reported earlier.…”

Section: Discussionmentioning

confidence: 91%

Risk assessment of cytologically indeterminate thyroid nodules with integrated molecular testing and repeat biopsy: a surgical decision-oriented tool

Guan

Tian

Zhang

et al. 2022

Preprint

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Background: The preoperative diagnosis of cytologically indeterminate thyroid nodules (ITNs) is very challenging. In this study, we aim to provide an integrated risk assessment for thyroid nodules with indeterminate cytology to guide surgical decision-making. Methods: The study retrospectively included 265 ITNs between June 2019 and April 2022. According to our integrated risk assessment that includes the results of blood tests, molecular tests and repeat fine-needle aspiration biopsy (FNAB), we divided the ITNs into high-risk and low-risk groups. Performance was evaluated with sensitivity, specificity, positive predictive value (PPV), negative predictive value(NPV), area under the receiver operating characteristiccurve (AUC), and the consistency between the risk evaluation and histological results. Results:Of the 265 ITNs, 87 were included in the risk assessment process. The risk assessment had a sensitivity of 84.1%, specificity of 83.3%, PPV of 95.1%, NPV of 57.7% and AUC of 0.837. The nodules with consistent results between the risk groups and histological outcomes, which included malignant cases in the high-risk group and benign cases in the low-risk group, accounted for 83.9% of all risk-assessed nodules. Conclusions: These data suggest that the integrated risk assessment might provide proper information for surgical decision-making in patients with ITNs.

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Risk stratification of indeterminate thyroid nodules by novel multigene testing: a study of Asians with a high risk of malignancy

Cited by 7 publications

References 42 publications

Molecular Testing for Thyroid Nodules: The Experience at McGill University Teaching Hospitals in Canada

Molecular Testing for Thyroid Nodules: The Experience at McGill University Teaching Hospitals in Canada

Risk assessment of cytologically indeterminate thyroid nodules with integrated molecular testing and repeat biopsy: a surgical decision-oriented tool

Risk assessment of cytologically indeterminate thyroid nodules with integrated molecular testing and repeat biopsy: a surgical decision-oriented tool

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