BACKGROUND: Thyroid fine-needle aspiration (FNA) plays a pivotal role in the evaluation of thyroid nodules. Up to 30% of cases are diagnosed as indeterminate by FNA, including atypia of undetermined significance, follicular lesion of undetermined significance, suspicious for a follicular neoplasm, and follicular neoplasm, with approximately two-thirds having a benign outcome. The gene expression classifier (GEC) test is a molecular test for cases with indeterminate cytology. The purpose of the current study was to examine the refining role of the GEC test within a single institution. METHODS: Retrospective analysis of all thyroid FNAs during a 20-month period after implementation of GEC was performed. Cases of indeterminate cytology with concomitant GEC testing were selected and divided further in 4 subgroups. Correlation with surgical follow-up, when available, was performed. The results were compared with previously published data from the study institution before the implementation of GEC testing. RESULTS: Among the 217 cases, there were 189 with indeterminate cytology, 42% of which were benign and 50% of which were suspicious by GEC. The excisional rate of atypia of undetermined significance-follicular lesion of undetermined significance in the pre-GEC category was 63%, which decreased to 35% in the post-GEC category, whereas the malignancy rate in the excised thyroids increased from 35% in the pre-GEC category to 47% in the post-GEC category. Similar findings also were obtained for suspicious for a follicular neoplasm-follicular neoplasm lesions. CONCLUSIONS: The strength of the GEC test appears to lie in its ability to reclassify 42% of indeterminate cytology cases as benign, thereby decreasing the number of unnecessary surgical procedures.
BACKGROUND: Thyroid fine-needle aspiration (FNA) plays a pivotal role in the evaluation of thyroid nodules. Up to 30% of cases are diagnosed as indeterminate by FNA, including atypia of undetermined significance, follicular lesion of undetermined significance, suspicious for a follicular neoplasm, and follicular neoplasm, with approximately two-thirds having a benign outcome. The gene expression classifier (GEC) test is a molecular test for cases with indeterminate cytology. The purpose of the current study was to examine the refining role of the GEC test within a single institution. METHODS: Retrospective analysis of all thyroid FNAs during a 20-month period after implementation of GEC was performed. Cases of indeterminate cytology with concomitant GEC testing were selected and divided further in 4 subgroups. Correlation with surgical follow-up, when available, was performed. The results were compared with previously published data from the study institution before the implementation of GEC testing. RESULTS: Among the 217 cases, there were 189 with indeterminate cytology, 42% of which were benign and 50% of which were suspicious by GEC. The excisional rate of atypia of undetermined significance-follicular lesion of undetermined significance in the pre-GEC category was 63%, which decreased to 35% in the post-GEC category, whereas the malignancy rate in the excised thyroids increased from 35% in the pre-GEC category to 47% in the post-GEC category. Similar findings also were obtained for suspicious for a follicular neoplasm-follicular neoplasm lesions. CONCLUSIONS: The strength of the GEC test appears to lie in its ability to reclassify 42% of indeterminate cytology cases as benign, thereby decreasing the number of unnecessary surgical procedures.
Authors: Mayumi Endo; Fadi Nabhan; Kyle Porter; Katie Roll; Lawrence A Shirley; Irina Azaryan; Dena Tonkovich; Jeanette Perlick; Laura E Ryan; Raheela Khawaja; Shumei Meng; John E Phay; Matthew D Ringel; Jennifer A Sipos Journal: Thyroid Date: 2019-07-17 Impact factor: 6.568
Authors: Mayumi Endo; Kyle Porter; Clarine Long; Irina Azaryan; John E Phay; Matthew D Ringel; Jennifer A Sipos; Fadi Nabhan Journal: J Clin Endocrinol Metab Date: 2020-11-01 Impact factor: 5.958
Authors: Sergio Vargas-Salas; José R Martínez; Soledad Urra; José Miguel Domínguez; Natalia Mena; Thomas Uslar; Marcela Lagos; Marcela Henríquez; Hernán E González Journal: Endocr Relat Cancer Date: 2017-12-18 Impact factor: 5.678
Authors: Ghobad Azizi; James M Keller; Michelle L Mayo; Kelé Piper; David Puett; Karly M Earp; Carl D Malchoff Journal: Endocrine Date: 2018-01-19 Impact factor: 3.633
Authors: Sylvan C Baca; Kristine S Wong; Kyle C Strickland; Howard T Heller; Matthew I Kim; Justine A Barletta; Edmund S Cibas; Jeffrey F Krane; Ellen Marqusee; Trevor E Angell Journal: Cancer Cytopathol Date: 2017-02-02 Impact factor: 5.284