Outcome of thyroid gene expression classifier testing in clinical practice.
OBJECTIVE
Gene expression classifiers can safely reduce diagnostic thyroid surgery for fine-needle aspiration cytology (FNAC) indeterminate thyroid nodules.


METHODS
Retrospective review, single-institution, single-practice surgeon.


METHODS
Three-year retrospective review of indeterminate FNAC that went on to gene expression classifier testing.


RESULTS
A total of 520 patients met American Thyroid Association guideline criteria for surgeon-performed ultrasound-guided FNAC for a thyroid nodule with on-site cytopathology. The indeterminate (Bethesda III or IV) FNAC rate was 9%. Prevalence of malignancy in FNAC indeterminate was 21%. Thirty-two cases went on to gene expression classifier testing. Fourteen were benign, 15 suspicious, and three with no result.


CONCLUSIONS
Benign gene expression classifier testing had an estimated negative predictive value of 100% during the study period. These patients have been observed for a mean and median duration of 14 and 7 months, respectively. In this small series, 14 of 29 patients with indeterminate FNAC were spared diagnostic surgery.


METHODS
4.
Department of Surgery, Head & Neck Multidisciplinary Clinic, Helen F. Graham Cancer Center, Christiana Care, Newark, Delaware, U.S.A.
Robert L
RL
Witt
D004247:DNA / Q000235:genetics*; D003937:Diagnosis, Differential; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D020869:Gene Expression Profiling / Q000379:methods*; D005786:Gene Expression Regulation; D019983:Guideline Adherence; D006801:Humans; D012189:Retrospective Studies; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000235:genetics / Q000601:surgery; D013965:Thyroidectomy / Q000592:standards*
D004247:DNA
Thyroid; fine needle aspiration cytology; gene expression testing