SUMMARY OF THE STUDY
From March 2014 to March 2015, 465 thyroid biopsy samples in 441 patients were diagnosed as indeterminate (AUS/FLUS) at the University of Pittsburgh Medical Center and all had the ThyroseqV2.1 test performed on biopsy specimen. The test found 3 parathyroid nodules and 462 thyroid lesions. ThyroseqV2.1 did not show a gene mutation in 431 (93%) of AUS/FLUS nodules. ThyroseqV2.1 did detect a gene mutation in 31(7%) nodules and 26 patients had thyroidectomy revealing 20 (77%) thyroid cancers. The majority (18) of these cancers were follicular variant of papillary thyroid cancer. Of the 431 patients with a negative ThyroseqV2.1, 69 patients still had surgery and 2 nodules (3%) were cancer. The most common gene mutations were NRAS and HRAS.
WHAT ARE THE IMPLICATIONS OF THIS STUDY?
The important finding of this study is that the Thyroseq2.1 molecular test can be valuable in the evaluation of indeterminate nodules with AUS/FLUS cytology. The data suggest that if the Thyroseq2.1 molecular test is negative (no gene mutations), there is 97% likelihood that the nodule is benign and surgery can be avoided. If the Thyroseq2.1 molecular test is positive for a gene mutation, there is a 77% change that the nodule is cancerous, so surgery is indicated. The results of this study are important to patients with indeterminate thyroid nodules to help determine which patients have a high or low risk for cancer, and thereby tailor management of either surgery or continued monitoring accordingly.
—Wendy Sacks, MD
ATA THYROID BROCHURE LINKS
Thyroid Nodules: http://www.thyroid.org/thyroid-nodules/
Thyroid cancer: http://www.thyroid.org/thyroid-cancer/