Correlating thyroid cytology and histopathology: Implications for molecular testing.

Head & Neck
Michael J ReedNitin A Pagedar

Abstract

A gene expression classifier (GEC) has been advocated in management of some indeterminate nodules without surgery. We assessed the potential negative predictive value (NPV) of the GEC at our academic center. Retrospectively, all cytologically indeterminate fine-needle aspirates (FNAs) diagnosed by University of Iowa cytopathologists over a 3-year period were identified. Histopathologic findings were recorded. Using published sensitivity and specificity, NPVs were calculated. Of 178 nodules (17, 135, and 26 in classes III, IV, and V, respectively), 71 (40%) were malignant. Prevalence of malignancy was 41%, 29%, and 96% for classes III, IV, and V, respectively. Using sensitivities and specificities for the GEC, NPVs were 91% for the cohort: 88%, 92%, and 26% for classes III, IV, and V, respectively. Molecular testing should be associated with an NPV no lower than that from clinical criteria alone. With the prevalences reported, GEC use may result in more missed cancer diagnoses. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1104-1106, 2016.

References

Oct 29, 2009·Thyroid : Official Journal of the American Thyroid Association·UNKNOWN American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid CancerR Michael Tuttle
May 24, 2011·Journal of the American College of Surgeons·John I LewCarmen C Solorzano
Jun 27, 2012·The New England Journal of Medicine·Erik K AlexanderBryan R Haugen
Aug 1, 2012·Acta Cytologica·Massimo BongiovanniZubair W Baloch
Feb 26, 2013·The Journal of Clinical Endocrinology and Metabolism·Matthew T OlsonMartha A Zeiger
Oct 25, 2013·The Journal of Clinical Endocrinology and Metabolism·Erik K AlexanderBryan R Haugen
May 2, 2014·The Journal of Clinical Endocrinology and Metabolism·Bryan McIverHoney Reddi

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Citations

May 20, 2017·Thyroid : Official Journal of the American Thyroid Association·Hernán E GonzálezSoledad Urra

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