Svetlana Paskaš1, Jelena Janković1, Vladan Živaljević2, Svetislav Tatić3, Vesna Božić4, Aleksandra Nikolić5, Dragica Radojković5, Svetlana Savin1, Dubravka Cvejić1. 1. Institute for the Application of Nuclear Energy, Department of Endocrinology and Radioimmunology, University of Belgrade, Belgrade, Serbia. 2. Center for Endocrine Surgery, Institute of Endocrinology, Diabetes, and Diseases of Metabolism, University of Belgrade, Belgrade, Serbia. 3. Institute of Pathology, Medical Faculty, University of Belgrade, Belgrade, Serbia. 4. Department of Endocrine and Cardiovascular Pathology, Clinical Center of Serbia, Belgrade, Serbia. 5. Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, Belgrade, Serbia.
Abstract
BACKGROUND: Fine-needle aspiration (FNA) has been employed for many years for examining thyroid nodules, and the cytology of aspirates is the primary determinant for whether thyroidectomy is indicated. Fifteen to thirty percent of thyroid nodules, not being clearly benign or malignant, fall into an indeterminate category. The main goals of molecular diagnostics for thyroid nodules are to prevent unnecessary surgery in patients with benign nodules and to stop patients with malignant nodules from being subjected to repeated operations. METHODS: This study was designed to evaluate the diagnostic utility of 4 markers in thyroid FNA cytology via testing for the BRAF V600E mutation and the expression of microRNA-221, microRNA-222, and galectin-3 protein in FNA samples with indeterminate cytology. RESULTS: A predictor model distinguishing benign samples from malignant samples on the basis of the 4 aforementioned markers was formulated. This decision model provided a sensitivity of 73.5%, a specificity of 89.8%, and a diagnostic accuracy of 75.7%. The positive predictive value was 80.6%, and the negative predictive value was 85.5%; this suggested that the prediction had good reliability. CONCLUSIONS: One hundred twenty FNA samples were examined, and 62 nodules were classified as benign with the proposed diagnostic algorithm. This resulted in a reduction of the initial 120 patients to 58 and thus decreased by half the number of persons undergoing surgery.
BACKGROUND: Fine-needle aspiration (FNA) has been employed for many years for examining thyroid nodules, and the cytology of aspirates is the primary determinant for whether thyroidectomy is indicated. Fifteen to thirty percent of thyroid nodules, not being clearly benign or malignant, fall into an indeterminate category. The main goals of molecular diagnostics for thyroid nodules are to prevent unnecessary surgery in patients with benign nodules and to stop patients with malignant nodules from being subjected to repeated operations. METHODS: This study was designed to evaluate the diagnostic utility of 4 markers in thyroid FNA cytology via testing for the BRAFV600E mutation and the expression of microRNA-221, microRNA-222, and galectin-3 protein in FNA samples with indeterminate cytology. RESULTS: A predictor model distinguishing benign samples from malignant samples on the basis of the 4 aforementioned markers was formulated. This decision model provided a sensitivity of 73.5%, a specificity of 89.8%, and a diagnostic accuracy of 75.7%. The positive predictive value was 80.6%, and the negative predictive value was 85.5%; this suggested that the prediction had good reliability. CONCLUSIONS: One hundred twenty FNA samples were examined, and 62 nodules were classified as benign with the proposed diagnostic algorithm. This resulted in a reduction of the initial 120 patients to 58 and thus decreased by half the number of persons undergoing surgery.
Authors: Salvatore Sciacchitano; Luca Lavra; Alessandra Ulivieri; Fiorenza Magi; Gian Paolo De Francesco; Carlo Bellotti; Leila B Salehi; Maria Trovato; Carlo Drago; Armando Bartolazzi Journal: Oncotarget Date: 2017-07-25