title: Use of molecular biomarkers in FNA specimens to personalize treatment for thyroid surgery.
abstract: BACKGROUND
  Accurate preoperative assessment of thyroid nodules with fine-needle aspiration biopsy (FNAB) continues to be a challenge, often resulting in unnecessary diagnostic surgical intervention. The detection of several novel gene mutations in differentiated thyroid cancer (DTC) over the last decade has led to the diagnostic use of these oncogenic alterations to improve FNAB sensitivity and specificity.
  
  
  RESULTS
  Thyroid oncogene mutations including BRAF, RAS, and RET/PTC are reviewed. The potential benefit of using this panel on fine-needle aspiration (FNA) cytology samples will be described.
  
  
  CONCLUSIONS
  Our use of ''reflexive'' molecular testing demonstrates its clinical value in conjunction with FNAB cytology, representing an application of personalized molecular medicine to guide appropriate surgical therapy.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, University of Pittsburgh Medical Center, Eye and Ear Institute, Pittsburgh, Pennsylvania.
authors.forename: Vikas
authors.initials: V
authors.lastname: Mehta
authors.forename: Yuri E
authors.initials: YE
authors.lastname: Nikiforov
authors.forename: Robert L
authors.initials: RL
authors.lastname: Ferris
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000235:genetics; D044963:Biopsy, Fine-Needle; D002291:Carcinoma, Papillary / Q000235:genetics* / Q000473:pathology* / Q000601:surgery; D004252:DNA Mutational Analysis; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics*; D051096:Proto-Oncogene Proteins c-ret / Q000235:genetics*; D013964:Thyroid Neoplasms / Q000235:genetics* / Q000473:pathology* / Q000601:surgery; D016606:Thyroid Nodule / Q000235:genetics / Q000473:pathology / Q000601:surgery; D013965:Thyroidectomy / Q000379:methods; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D051096:Proto-Oncogene Proteins c-ret; D048493:Proto-Oncogene Proteins B-raf