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Multiplatformmolecular testperformance inindeterminate thyroidnodules Mark A. LupoAnn E. WaltsJ. Woody Sistrunk2020 год

Multiplatform molecular test performance in indeterminate thyroid nodules
статья из журнала

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Аннотация: Approximately 25% of thyroid nodule fine-needle aspirates (FNAs) have cytology that is indeterminate for malignant disease. Accurate risk stratification of these FNAs with ancillary testing would reduce unnecessary thyroid surgery.We evaluated the performance of an ancillary multiplatform test (MPTX) that has three diagnostic categories (negative, moderate, and positive). MPTX includes the combination of a mutation panel (ThyGeNEXT®) and a microRNA risk classifier (ThyraMIR®). A blinded, multicenter study was performed using consensus histopathology diagnosis among three pathologists to validate test performance.Unanimous consensus diagnosis was reached in 197 subjects with indeterminate thyroid nodules; 36% had disease. MPTX had 95% sensitivity (95% CI,86%-99%) and 90% specificity (95% CI,84%-95%) for disease in prevalence adjusted nodules with Bethesda III and IV cytology. Negative MPTX results ruledout disease with 97% negative predictive value (NPV; 95% CI,91%-99%) at a 30% disease prevalence, while positive MPTX results ruledin high risk disease with 75% positive predictive value (PPV; 95% CI,60%-86%). Such results are expected in four out of five Bethesda III and IV nodules tested, including RAS positive nodules in which the microRNA classifier was useful in rulingin disease. 90% of mutation panel false positives were due to analytically verified RAS mutations detected in benign adenomas. Moderate MPTX results had a moderate rate of disease (39%, 95% CI,23%-54%), primarily due to RAS mutations, wherein the possibility of disease could not be excluded.Our results emphasize that decisions for surgery should not solely be based on RAS or RAS-like mutations. MPTX informs management decisions while accounting for these challenges.
Год издания: 2020
Авторы: Mark A. Lupo, Ann E. Walts, J. Woody Sistrunk, Thomas J. Giordano, Peter M. Sadow, Nicole Massoll, Ryan Campbell, Sara Jackson, Nicole Toney, Christina Narick, Gyanendra Kumar, Alidad Mireskandari, Sydney Finkelstein, Shikha Bose
Издательство: Wiley
Источник: Diagnostic Cytopathology
Ключевые слова: Thyroid Cancer Diagnosis and Treatment, Neuroendocrine Tumor Research Advances, Lung Cancer Diagnosis and Treatment
Другие ссылки: Diagnostic Cytopathology (PDF)
Diagnostic Cytopathology (HTML)
Deep Blue (University of Michigan) (PDF)
Deep Blue (University of Michigan) (HTML)
PubMed Central (HTML)
PubMed (HTML)