Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Dec;148(6):1170-6; discussion 1176-7.
doi: 10.1016/j.surg.2010.09.025.

A prospective study evaluating the accuracy of using combined clinical factors and candidate diagnostic markers to refine the accuracy of thyroid fine needle aspiration biopsy

Aarti Mathur  1 , Julie Weng, Willieford Moses, Seth M Steinberg, Reza Rahbari, Mio Kitano, Elham Khanafshar, Britt-Marie Ljung, Quan-Yang Duh, Orlo H Clark, Electron Kebebew
Affiliations

A prospective study evaluating the accuracy of using combined clinical factors and candidate diagnostic markers to refine the accuracy of thyroid fine needle aspiration biopsy

Aarti Mathur et al. Surgery. 2010 Dec.

Erratum in

  • Surgery. 2012 Feb;151(2):343. Rahabari, Reza [corrected to Rahbari, Reza]

Abstract

Background: Approximately 30% of fine needle aspiration biopsies of the thyroid have inconclusive results. We conducted a prospective trial to determine whether clinical and molecular markers could be used in combination to improve the accuracy of thyroid fine needle aspiration biopsy.

Methods: Clinical, tumor genotyping for common somatic mutations (BRAF V600E, NRAS, KRAS, RET/PTC1, RET/PTC3, and NTRK1), and the gene expression levels of 6 candidate diagnostic markers were analyzed by univariate and multivariate methods in 341 patients to determine whether they could distinguish reliably benign from malignant thyroid neoplasms, and a scoring model was derived.

Results: By a multivariate analysis, fine needle aspiration biopsy cytology classification, the presence of a NRAS mutation, and the tissue inhibitor of metalloproteinase 1 expression level were associated jointly with malignancy. The overall accuracy of the scoring model, including these 3 variables, to distinguish benign from malignant thyroid tumors was 91%, including 67% for the indeterminate and 77% for the suspicious FNA subgroups.

Conclusion: Fine needle aspiration biopsy cytology classification, the presence of NRAS mutation, and tissue inhibitor of metalloproteinase 1 messenger RNA expression levels in combination provide a greater diagnostic accuracy than fine needle aspiration biopsy cytology alone to allow selection of more definitive initial operative treatment. The sensitivity of the scoring model, however, was too low to avoid the need for diagnostic thyroidectomies for indeterminate fine needle aspiration biopsy findings.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow Diagram demonstrating FNA biopsy diagnosis and management.
See this image and copyright information in PMC

References

    1. http://seer.cancer.gov/statfacts/html/thyro.html

    1. Vander JB, Gaston EA, Dawber TR. The significance of nontoxic thyroid nodules. Final report of a 15-year study of the incidence of thyroid malignancy. Ann Intern Med. 1968;69(3):537–40. - PubMed
    1. Castro MR, Gharib H. Thyroid fine needle aspiration biopsy: progress, practice, and pitfalls. Endocr Prac. 2003;9:128–136. - PubMed
    1. Blansfield JA, Sack MJ, Kukora JS. Recent experience with preoperative fine-needle aspiration biopsy of thyroid nodules in a community hospital. Arch Surg. 2002;137:818–821. - PubMed
    1. Renshaw AA. Accuracy of thyroid fine-needle aspiration using receiver operator characteristic curves. Am J Clin Pathol. 2001;116:477–482. - PubMed

MeSH terms