BACKGROUND: The preoperative diagnosis of thyroid nodules primarily depends upon fine needle aspiration (FNA) cytology. However, up to 25% of FNA samples have associated "suspicious or indeterminate", but not diagnostic cytologic reports, resulting in difficulty deciding appropriate clinical management for these patients. We hypothesize that the use of molecular markers as an adjunct to FNA cytology can improve the distinction of benign from malignant nodules that have associated suspicious or indeterminate cytology. METHODS: Using microarray analysis, we previously identified and reported on 75 genes useful in the distinction of benign versus malignant thyroid nodules. In the present study, we have further validated the expression of 14 of these markers in a large number of thyroid samples by immunohistochemistry (IHC) analysis of 154 thyroid tumors and quantitative real-time RT-PCR (QRT-PCR) analysis of 95 FNA samples. Of the 154 tumors analyzed by IHC, 44 samples (29%) had associated suspicious or indeterminate FNA cytology. RESULTS: Receiver operating characteristic using three-gene model, (HMGA2, MRC2, and SFN) analysis for the detection of malignant nodules resulted in areas under the curve (AUCs) of≥0.95 (80% sensitivity; 100% specificity) and≥0.84 (71% sensitivity; 84% specificity) for the IHC data in tumors, and QRT-PCR data in FNA samples, respectively. CONCLUSIONS: Our results suggest that a three-gene model for the cytological diagnosis of indeterminate thyroid nodules is both feasible and promising. Implementation of this as an adjunct to thyroid cytology may significantly impact the clinical management of patients with suspicious or indeterminate thyroid FNA nodules.
BACKGROUND: The preoperative diagnosis of thyroid nodules primarily depends upon fine needle aspiration (FNA) cytology. However, up to 25% of FNA samples have associated "suspicious or indeterminate", but not diagnostic cytologic reports, resulting in difficulty deciding appropriate clinical management for these patients. We hypothesize that the use of molecular markers as an adjunct to FNA cytology can improve the distinction of benign from malignant nodules that have associated suspicious or indeterminate cytology. METHODS: Using microarray analysis, we previously identified and reported on 75 genes useful in the distinction of benign versus malignant thyroid nodules. In the present study, we have further validated the expression of 14 of these markers in a large number of thyroid samples by immunohistochemistry (IHC) analysis of 154 thyroid tumors and quantitative real-time RT-PCR (QRT-PCR) analysis of 95 FNA samples. Of the 154 tumors analyzed by IHC, 44 samples (29%) had associated suspicious or indeterminate FNA cytology. RESULTS: Receiver operating characteristic using three-gene model, (HMGA2, MRC2, and SFN) analysis for the detection of malignant nodules resulted in areas under the curve (AUCs) of≥0.95 (80% sensitivity; 100% specificity) and≥0.84 (71% sensitivity; 84% specificity) for the IHC data in tumors, and QRT-PCR data in FNA samples, respectively. CONCLUSIONS: Our results suggest that a three-gene model for the cytological diagnosis of indeterminate thyroid nodules is both feasible and promising. Implementation of this as an adjunct to thyroid cytology may significantly impact the clinical management of patients with suspicious or indeterminate thyroid FNA nodules.
Authors: Barbara Jarzab; Malgorzata Wiench; Krzysztof Fujarewicz; Krzysztof Simek; Michal Jarzab; Malgorzata Oczko-Wojciechowska; Jan Wloch; Agnieszka Czarniecka; Ewa Chmielik; Dariusz Lange; Agnieszka Pawlaczek; Sylwia Szpak; Elzbieta Gubala; Andrzej Swierniak Journal: Cancer Res Date: 2005-02-15 Impact factor: 12.701
Authors: Janete M Cerutti; Flavia R M Latini; Claudia Nakabashi; Rosana Delcelo; Victor P Andrade; Marcelo João Amadei; Rui M B Maciel; Flavio C Hojaij; Donna Hollis; Jennifer Shoemaker; Gregory J Riggins Journal: Clin Cancer Res Date: 2006-06-01 Impact factor: 12.531
Authors: Chiara Mazzanti; Martha A Zeiger; Nick G Costouros; Christopher Umbricht; William H Westra; Danelle Smith; Helina Somervell; Generoso Bevilacqua; H Richard Alexander; Steven K Libutti; Nick Costourous Journal: Cancer Res Date: 2004-04-15 Impact factor: 12.701
Authors: Nijaguna B Prasad; Helina Somervell; Ralph P Tufano; Alan P B Dackiw; Michael R Marohn; Joseph A Califano; Yongchun Wang; William H Westra; Douglas P Clark; Christopher B Umbricht; Steven K Libutti; Martha A Zeiger Journal: Clin Cancer Res Date: 2008-06-01 Impact factor: 12.531
Authors: Nijaguna B Prasad; Anne C Fischer; Alice Y Chuang; Jerry M Wright; Ting Yang; Hua-Ling Tsai; William H Westra; Nanette J Liegeois; Allan D Hess; Anthony P Tufaro Journal: Mod Pathol Date: 2013-12-20 Impact factor: 7.842