Performance of a multigene genomic classifier and clinical parameters in predicting malignancy in a Southeast Asian cohort of patients with cytologically indeterminate thyroid nodules

被引：1

作者：

Yang, Samantha Peiling ^{[1
,2
,3
]}

Nga, Min En ^{[4
]}

Bundele, Manish Mahadeorao ^{[5
]}

Chiosea, Simion I. ^{[6
]}

Tan, Sze Hwa ^{[7
]}

Lum, Jeffrey H. Y. ^{[4
]}

Parameswaran, Rajeev ^{[8
,9
]}

Lim, Ming Yann ^{[10
]}

Li, Hao ^{[10
]}

Cheah, Wei Keat ^{[8
,9
,11
]}

Sek, Kathleen Su-Yen ^{[2
,3
]}

Tan, Andre Teck Huat ^{[2
,3
]}

Loh, Thomas Kwok Seng ^{[12
,13
]}

Ngiam, Kee Yuan ^{[8
,9
]}

Tan, Wee Boon ^{[8
,9
]}

Huang, Xinyong ^{[14
]}

Ho, Thomas Wai Thong ^{[15
]}

Lim, Keng Hua ^{[10
]}

Lim, Chwee Ming ^{[16
,17
]}

Singaporewalla, Reyaz M. ^{[18
]}

Rao, Anil Dinkar ^{[18
]}

Rao, Nandini C. L. ^{[5
]}

Chua, Dennis Yu Kim ^{[10
]}

Chin, David Chao-Wu ^{[14
]}

Wald, Abigail I. ^{[6
]}

Livolsi, Virginia A. ^{[19
]}

Nikiforov, Yuri E. ^{[6
]}

Tai, E. Shyong ^{[2
,3
]}

机构：

[1] NUHS Tower Block,1E Kent Ridge Rd,Level 10, Singapore 119228, Singapore

[2] Natl Univ Singapore Hosp, Dept Med, Endocrinol Div, Singapore, Singapore

[3] Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Med, Endocrinol Div, Singapore, Singapore

[4] Natl Univ Singapore Hosp, Dept Pathol, Singapore, Singapore

[5] Tan Tock Seng Hosp, Dept Pathol, Singapore, Singapore

[6] Univ Pittsburgh, Dept Pathol, Pittsburgh, PA USA

[7] Changi Gen Hosp, Dept Pathol, Singapore, Singapore

[8] Natl Univ Singapore Hosp, Dept Surg, Div Endocrine Surg, Singapore, Singapore

[9] Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Surg, Div Endocrine Surg, Singapore, Singapore

[10] Tan Tock Seng Hosp, Dept Otorhinolaryngol, Singapore, Singapore

[11] Ng Teng Fong Gen Hosp, Dept Gen Surg, Div Breast & Endocrine Surg, Singapore, Singapore

[12] Natl Univ Singapore Hosp, Dept Otolaryngol Head & Neck Surg, Singapore, Singapore

[13] Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Otolaryngol, Singapore, Singapore

[14] Changi Gen Hosp, Dept Otorhinolaryngol Head & Neck Surg, Singapore, Singapore

[15] Tan Tock Seng Hosp, Dept Gen Surg, Singapore, Singapore

[16] Singapore Gen Hosp, Dept Otolaryngol Head & Neck Surg, Singapore, Singapore

[17] Duke Natl Univ Singapore Med Sch, Dept Otolaryngol Head & Neck Surg, Singapore, Singapore

[18] Khoo Teck Puat Hosp, Dept Gen Surg, Endocrine & Head Neck Surg Unit, Singapore, Singapore

[19] Univ Penn, Dept Pathol & Lab Med, Med Ctr, Philadelphia, PA USA

来源：

CANCER CYTOPATHOLOGY | 2024年 / 132卷 / 05期

关键词：

clinical utility; clinical validation; thyroid cancer prediction; thyroid cancer prognostication; thyroid molecular test; ThyroSeq; FINE-NEEDLE-ASPIRATION; ASSOCIATION GUIDELINES; ARCHITECTURAL ATYPIA; TASK-FORCE; MANAGEMENT; CANCER; NEOPLASM; NUCLEAR; ULTRASOUND; DIAGNOSIS;

D O I：

10.1002/cncy.22796

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Most thyroid nodules are benign. It is important to determine the likelihood of malignancy in such nodules to avoid unnecessary surgery. The primary objective of this study was to characterize the genetic landscape and the performance of a multigene genomic classifier in fine-needle aspiration (FNA) biopsies of cytologically indeterminate thyroid nodules in a Southeast Asian cohort. The secondary objective was to assess the predictive contribution of clinical characteristics to thyroid malignancy. Methods: This prospective, multicenter, blinded study included 132 patients with 134 nodules. Molecular testing (MT) with ThyroSeq v3 was performed on clinical or ex-vivo FNA samples. Centralized pathology review also was performed. Results: Of 134 nodules, consisting of 61% Bethesda category III, 20% category IV, and 19% category V cytology, and 56% were histologically malignant. ThyroSeq yielded negative results in 37.3% of all FNA samples and in 42% of Bethesda category III-IV cytology nodules. Most positive samples had RAS-like (41.7%), followed by BRAF-like (22.6%), and high-risk (17.9%) alterations. Compared with North American patients, the authors observed a higher proportion of RAS-like mutations, specifically NRAS, in Bethesda categories III and IV and more BRAF-like mutations in Bethesda category III. The test had sensitivity, specificity, negative predictive value, and positive predictive value of 89.6%, 73.7%, 84.0%, and 82.1%, respectively. The risk of malignancy was predicted by positive MT and high-suspicion ultrasound characteristics according to American Thyroid Association criteria. Conclusions: Even in the current Southeast Asian cohort with nodules that had a high pretest cancer probability, MT could lead to potential avoidance of diagnostic surgery in 42% of patients with Bethesda category III-IV nodules. MT positivity was a stronger predictor of malignancy than clinical parameters.

引用

页码：309 / 319

页数：11

共 22 条

[21] Epidemiologic, Clinical, Ultrasonographic, and Cytological Features of Thyroid Nodules in Predicting Malignancy Risk: A Retrospective Study of 442 French Afro-Caribbean Patients
Joseph-Auguste, Johan
Lin, Lucien
Demar, Magalie
Duffas, Olivier
Molinie, Vincent
Sulpicy, Caroline
Dorival, Marie-Josee
Luxembourger, Olivier
Sabbah, Nadia
INTERNATIONAL JOURNAL OF ENDOCRINOLOGY, 2020, 2020
[22] Thyroid nodules with indeterminate cytology: association between nodule size, histopathological characteristics and clinical outcome in differentiated thyroid carcinomas - a multicenter retrospective cohort study on 761 patients
Cozzani, Federico
Bettini, Dario
Rossini, Matteo
Bonati, Elena
Nuzzo, Simona
Loderer, Tommaso
Pedrazzi, Giuseppe
Zaccaroni, Alberto
Del Rio, Paolo
UPDATES IN SURGERY, 2021, 73 (05) : 1923 - 1930

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