BACKGROUND: Activating point mutations of the RAS gene (NRAS, HRAS, and KRAS) can be seen in benign and malignant thyroid tumors; among these, NRAS mutations are more commonly seen. This study was conducted to evaluate the thyroid risk of malignancy (ROM) associated with RAS mutations in thyroid fine-needle aspiration (FNA) at the authors' institution. METHODS: The authors searched their electronic database system between January 2015 and May 2021 for thyroid FNA cases with any type of RAS mutation. Molecular alterations were identified with the ThyroSeq Genomic Classifier, ThyGeNEXT (thyroid oncogene panel)/ThyraMIR (miRNA classifier), or ThyroSure gene panel. RESULTS: A total of 127 cases (age, 51 ± 14 years; 100 females and 27 males) were identified, and 72 had histologic follow-up. The overall ROM associated with RAS mutations (with or without any other molecular alterations) was 29%, whereas the ROM was lower (18%) with RAS mutations only. Isolated NRAS, HRAS, and KRAS mutation-associated ROMs were 15%, 27%, and 14%, respectively. Among these RAS-mutated cases, the cases with a Bethesda category IV cytologic diagnosis had a higher ROM than the cases with a category III diagnosis (38% vs 17%). Twenty-one histologically confirmed malignant cases were mostly classified on cytology as category IV lesions (14 of 34; 41%), and the remainder were either category III (6 of 35; 17%) or V lesions (1 of 1; 100%). CONCLUSIONS: This study demonstrated that the overall RAS mutation-associated ROM in thyroid FNA was intermediate (29%), and isolated HRAS mutations appeared to have a higher ROM (27%) than NRAS and KRAS mutations (15% and 14%, respectively).
BACKGROUND: Activating point mutations of the RAS gene (NRAS, HRAS, and KRAS) can be seen in benign and malignant thyroid tumors; among these, NRAS mutations are more commonly seen. This study was conducted to evaluate the thyroid risk of malignancy (ROM) associated with RAS mutations in thyroid fine-needle aspiration (FNA) at the authors' institution. METHODS: The authors searched their electronic database system between January 2015 and May 2021 for thyroid FNA cases with any type of RAS mutation. Molecular alterations were identified with the ThyroSeq Genomic Classifier, ThyGeNEXT (thyroid oncogene panel)/ThyraMIR (miRNA classifier), or ThyroSure gene panel. RESULTS: A total of 127 cases (age, 51 ± 14 years; 100 females and 27 males) were identified, and 72 had histologic follow-up. The overall ROM associated with RAS mutations (with or without any other molecular alterations) was 29%, whereas the ROM was lower (18%) with RAS mutations only. Isolated NRAS, HRAS, and KRAS mutation-associated ROMs were 15%, 27%, and 14%, respectively. Among these RAS-mutated cases, the cases with a Bethesda category IV cytologic diagnosis had a higher ROM than the cases with a category III diagnosis (38% vs 17%). Twenty-one histologically confirmed malignant cases were mostly classified on cytology as category IV lesions (14 of 34; 41%), and the remainder were either category III (6 of 35; 17%) or V lesions (1 of 1; 100%). CONCLUSIONS: This study demonstrated that the overall RAS mutation-associated ROM in thyroid FNA was intermediate (29%), and isolated HRAS mutations appeared to have a higher ROM (27%) than NRAS and KRAS mutations (15% and 14%, respectively).
Authors: Vera A Paulson; Priyanka Shivdasani; Trevor E Angell; Edmund S Cibas; Jeffrey F Krane; Neal I Lindeman; Erik K Alexander; Justine A Barletta Journal: Thyroid Date: 2017-02-24 Impact factor: 6.568
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Authors: Pablo Valderrabano; Laila Khazai; Marino E Leon; Zachary J Thompson; Zhenjun Ma; Christine H Chung; Julie E Hallanger-Johnson; Kristen J Otto; Kara D Rogers; Barbara A Centeno; Bryan McIver Journal: Endocr Relat Cancer Date: 2017-01-19 Impact factor: 5.678
Authors: Snehal G Patel; Sally E Carty; Kelly L McCoy; N Paul Ohori; Shane O LeBeau; Raja R Seethala; Marina N Nikiforova; Yuri E Nikiforov; Linwah Yip Journal: Surgery Date: 2016-11-15 Impact factor: 3.982
Authors: Juan C Hernandez-Prera; Pablo Valderrabano; Jordan H Creed; Janis V de la Iglesia; Robbert J C Slebos; Barbara A Centeno; Valentina Tarasova; Julie Hallanger-Johnson; Colleen Veloski; Kristen J Otto; Bruce M Wenig; Sean J Yoder; Cesar A Lam; Derek S Park; Alexander R Anderson; Natarajan Raghunand; Anders Berglund; Jimmy Caudell; Travis A Gerke; Christine H Chung Journal: Thyroid Date: 2020-08-25 Impact factor: 6.568
Authors: Yuri E Nikiforov; Sally E Carty; Simon I Chiosea; Christopher Coyne; Umamaheswar Duvvuri; Robert L Ferris; William E Gooding; Shane O LeBeau; N Paul Ohori; Raja R Seethala; Mitchell E Tublin; Linwah Yip; Marina N Nikiforova Journal: Thyroid Date: 2015-09-10 Impact factor: 6.568
Authors: Whitney S Goldner; Trevor E Angell; Sallie Lou McAdoo; Joshua Babiarz; Peter M Sadow; Fadi A Nabhan; Christian Nasr; Richard T Kloos Journal: Thyroid Date: 2019-09-27 Impact factor: 6.568
Authors: Andrea M Ciarletto; Christina Narick; Carl D Malchoff; Nicole A Massoll; Emmanuel Labourier; Keith Haugh; Alidad Mireskandari; Sydney D Finkelstein; Gyanendra Kumar Journal: Cancer Cytopathol Date: 2020-10-05 Impact factor: 5.284