| Autor: |
Słowińska-Klencka D; Department of Morphometry of Endocrine Glands, Medical University of Lodz, Pomorska 251 St., 92-213 Lodz, Poland., Popowicz B; Department of Morphometry of Endocrine Glands, Medical University of Lodz, Pomorska 251 St., 92-213 Lodz, Poland., Kulczycka-Wojdala D; Research Laboratory CoreLab, Medical University of Lodz, Mazowiecka 6/8 St., 92-215 Lodz, Poland., Szymańska B; Research Laboratory CoreLab, Medical University of Lodz, Mazowiecka 6/8 St., 92-215 Lodz, Poland., Duda-Szymańska J; Department of Pathomorphology, Medical University of Lodz, Pomorska 251 St., 92-213 Lodz, Poland., Wojtaszek-Nowicka M; Department of Clinical Endocrinology, Medical University of Lodz, Pomorska 251 St., 92-213 Lodz, Poland., Kaczka K; Department of General and Oncological Surgery, Surgical Clinical Sciences, Medical University of Lodz, Pomorska 251 St., 92-213 Lodz, Poland., Klencki M; Department of Morphometry of Endocrine Glands, Medical University of Lodz, Pomorska 251 St., 92-213 Lodz, Poland. |
| Abstrakt: |
The aim of the study was to analyze the diagnostic usefulness of the combined assessment of the ultrasound risk category of the nodule (evaluated with EU-TIRADS system), the presence of BRAF V600E mutation and the expression of selected microRNAs (miR-146b, miR-221 and miR-222) in Bethesda category III thyroid nodules, separately for cases with nuclear atypia (AUS-nuclear) and cases with other types of atypia (AUS-other). We evaluated 161 nodules (66 AUS-nuclear and 95 AUS-other) with known results of postoperative histopathological examination. The rate of cancer and the rate of PTC among cancers were nearly three times higher in the AUS-nuclear than the AUS-other group. For AUS-nuclear nodules, the most effective diagnostic panel included, in addition to repeat FNA, the assessment of BRAF V600E mutation and the expression of miR-146b and miR-222 (sensitivity: 93.5%, specificity: 80.0%). For AUS-other nodules, a two-step procedure was most effective: at the first stage, forgoing surgical treatment in subjects with a benign repeat FNA outcome, and, at the second stage, the assessment of miR-222 expression and the EU-TIRADS category (sensitivity: 92.3%, specificity: 76.8%). The optimal use of molecular methods in the diagnostics of category III thyroid nodules requires a separate approach for nodules with nuclear atypia and nodules with other types of atypia. |
