Introduction: The management of patients with indeterminate thyroid nodules, which account for 10-25% of thyroid fine needle aspiration biopsies (FNABs), is still very challenging. Aim: To verify the utility of the seven-gene panel in combination with ultrasound features in the clinical management of indeterminate thyroid nodules. Results: The study group included 188 indeterminate thyroid nodules, divided into TIR3A (56.4%) and TIR3B (43.6%). A significant correlation between US categories and both cytological and molecular results was observed. In detail, TIR3B cytology was more frequent in EU-TIRADS 4 and 5 nodules (54.7 and 50%, respectively) than in EU-TIRADS 2 and 3 nodules (31%, p = 0.04). Similarly, the rate of a nodule with a mutation increased with the increase of US risk class (6.0% in EU-TIRADS 2 and 3, 9.3% in EUTIRADS-4 and 27.8% in EUTIRAD-5, p = 0.01). Among thyroid nodules submitted to surgery, final histology was benign in 61.4% nodules, while malignancy was diagnosed in 38.6% nodules. Using US score as tool for decision-making in TIR3A subgroup, we correctly classified 64.5% of thyroid nodules. The second tool (seven-gene panel test) was used in the subgroup of US high-risk nodules. By multiple tests with a series approach (US in all cases and US plus seven-gene panel in US high risk nodules) 84% of cases were correctly classified. In TIR3B nodules, using only seven-gene panel as tool for decision making, we correctly classified 61.9% of indeterminate nodules. By multiple tests with series approach (seven-gene panel in all cases and seven-gene panel plus US score in non-mutated nodules) only a slight improvement of thyroid nodule classification (66.6%) was observed. Conclusions: US score seems able to correctly discriminate between TIR3A nodules in which a conservative approach may be used, and those in which additional test, such as molecular test, may be indicated. On the contrary, in TIR3B nodules both US risk stratification and seven-gene panel seem to be of little use, because the risk of thyroid cancer remains high regardless of US score and mutational status.
Introduction: The management of patients with indeterminate thyroid nodules, which account for 10-25% of thyroid fine needle aspiration biopsies (FNABs), is still very challenging. Aim: To verify the utility of the seven-gene panel in combination with ultrasound features in the clinical management of indeterminate thyroid nodules. Results: The study group included 188 indeterminate thyroid nodules, divided into TIR3A (56.4%) and TIR3B (43.6%). A significant correlation between US categories and both cytological and molecular results was observed. In detail, TIR3B cytology was more frequent in EU-TIRADS 4 and 5 nodules (54.7 and 50%, respectively) than in EU-TIRADS 2 and 3 nodules (31%, p = 0.04). Similarly, the rate of a nodule with a mutation increased with the increase of US risk class (6.0% in EU-TIRADS 2 and 3, 9.3% in EUTIRADS-4 and 27.8% in EUTIRAD-5, p = 0.01). Among thyroid nodules submitted to surgery, final histology was benign in 61.4% nodules, while malignancy was diagnosed in 38.6% nodules. Using US score as tool for decision-making in TIR3A subgroup, we correctly classified 64.5% of thyroid nodules. The second tool (seven-gene panel test) was used in the subgroup of US high-risk nodules. By multiple tests with a series approach (US in all cases and US plus seven-gene panel in US high risk nodules) 84% of cases were correctly classified. In TIR3B nodules, using only seven-gene panel as tool for decision making, we correctly classified 61.9% of indeterminate nodules. By multiple tests with series approach (seven-gene panel in all cases and seven-gene panel plus US score in non-mutated nodules) only a slight improvement of thyroid nodule classification (66.6%) was observed. Conclusions: US score seems able to correctly discriminate between TIR3A nodules in which a conservative approach may be used, and those in which additional test, such as molecular test, may be indicated. On the contrary, in TIR3B nodules both US risk stratification and seven-gene panel seem to be of little use, because the risk of thyroid cancer remains high regardless of US score and mutational status.
Authors: M Jinih; N Foley; O Osho; L Houlihan; A A Toor; J Z Khan; A A Achakzai; H P Redmond Journal: Eur J Surg Oncol Date: 2016-11-22 Impact factor: 4.424
Authors: R Cinti; L Yin; K Ilc; N Berger; F Basolo; S Cuccato; R Giannini; G Torre; P Miccoli; P Amati; G Romeo; R Corvi Journal: Cytogenet Cell Genet Date: 2000
Authors: Robert L Ferris; Zubair Baloch; Victor Bernet; Amy Chen; Thomas J Fahey; Ian Ganly; Steven P Hodak; Electron Kebebew; Kepal N Patel; Ashok Shaha; David L Steward; Ralph P Tufano; Sam M Wiseman; Sally E Carty Journal: Thyroid Date: 2015-06-24 Impact factor: 6.568
Authors: Yuri E Nikiforov; David L Steward; Toni M Robinson-Smith; Bryan R Haugen; Joshua P Klopper; Zhaowen Zhu; James A Fagin; Mercedes Falciglia; Katherine Weber; Marina N Nikiforova Journal: J Clin Endocrinol Metab Date: 2009-03-24 Impact factor: 5.958
Authors: David L Steward; Sally E Carty; Rebecca S Sippel; Samantha Peiling Yang; Julie A Sosa; Jennifer A Sipos; James J Figge; Susan Mandel; Bryan R Haugen; Kenneth D Burman; Zubair W Baloch; Ricardo V Lloyd; Raja R Seethala; William E Gooding; Simion I Chiosea; Cristiane Gomes-Lima; Robert L Ferris; Jessica M Folek; Raheela A Khawaja; Priya Kundra; Kwok Seng Loh; Carrie B Marshall; Sarah Mayson; Kelly L McCoy; Min En Nga; Kee Yuan Ngiam; Marina N Nikiforova; Jennifer L Poehls; Matthew D Ringel; Huaitao Yang; Linwah Yip; Yuri E Nikiforov Journal: JAMA Oncol Date: 2019-02-01 Impact factor: 31.777
Authors: James J Figge; William E Gooding; David L Steward; Linwah Yip; Rebecca S Sippel; Samantha Peiling Yang; Randall P Scheri; Jennifer A Sipos; Susan J Mandel; Sarah E Mayson; Kenneth D Burman; Jessica M Folek; Bryan R Haugen; Julie A Sosa; Rajeev Parameswaran; Wee Boon Tan; Yuri E Nikiforov; Sally E Carty Journal: Thyroid Date: 2021-09-01 Impact factor: 6.568