Combination of the gene-expression classifier (GEC), with its high negative predictive value, and the BRAF mutation test, with its high specificity, might have a synergistic effect in the diagnosis of thyroid nodules with indeterminate cytology. However, Kloos et al. demonstrate that the BRAF test is of no additional benefit in nodules categorized as 'benign' by GEC.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Baloch, Z. W. et al. Diagnostic terminology and morphologic criteria for cytologic diagnosis of thyroid lesions: a synopsis of the National Cancer Institute Thyroid Fine-Needle Aspiration State of the Science Conference. Diagn. Cytopathol. 36, 425–437 (2008).
Cooper, D. S. et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 19, 1167–1214 (2009).
Alexander, E. K. et al. Preoperative diagnosis of benign thyroid nodules with indeterminate cytology. N. Engl. J. Med. 367, 705–715 (2012).
Nikiforov, Y. E. et al. Impact of mutational testing on the diagnosis and management of patients with cytologically indeterminate thyroid nodules: a prospective analysis of 1056 FNA samples. J. Clin. Endocrinol. Metab. 96, 3390–3397 (2011).
Keutgen, X. M. et al. A panel of four miRNAs accurately differentiates malignant from benign indeterminate thyroid lesions on fine needle aspiration. Clin. Cancer Res. 18, 2032–2038 (2012).
Kloos, R. T. et al. Does addition of BRAF V600E Mutation testing modify sensitivity or specificity of the Afirma gene expression classifier in cytologically indeterminate thyroid nodules? J. Clin. Endocrinol. Metab. http://dx.doi.org/10.1210/jc.2012-3762
Kimura, E. T. et al. High prevalence of BRAF mutations in thyroid cancer: genetic evidence for constitutive activation of the RET/PTC–RAS–BRAF signaling pathway in papillary thyroid carcinoma. Cancer Res. 63, 1454–1457 (2003).
Kwak, J. Y. et al. How to combine ultrasound and cytological information in decision making about thyroid nodules. Eur. Radiol. 19, 1923–1931 (2009).
Lee, S. W. et al. Combined categorical reporting systems of US and cytology findings for thyroid nodules: guidance on repeat fine-needle aspiration cytology. Radiology 266, 956–963 (2013).
Cantisani, V. et al. Q-elastography in the presurgical diagnosis of thyroid nodules with indeterminate cytology. PLoS ONE 7, e50725 (2012).
Author information
Authors and Affiliations
Ethics declarations
Competing interests
The authors declare no competing financial interests.
Rights and permissions
About this article
Cite this article
Kwak, J., Kim, EK. Indeterminate thyroid nodules—added testing, added value?. Nat Rev Endocrinol 9, 321–323 (2013). https://doi.org/10.1038/nrendo.2013.79
Published:
Issue Date:
DOI: https://doi.org/10.1038/nrendo.2013.79
This article is cited by
-
Nodular thyroid disease in the elderly: novel molecular approaches for the diagnosis of malignancy
Aging Clinical and Experimental Research (2017)