Preoperative detection of malignancy in fine-needle aspiration cytology (FNAC) smears with indeterminate cytology (Bethesda III, IV) by a combined molecular classifier
| Autor: | Gevork A. Katanyan, Yulia A Veryaskina, Sergei A Lukyanov, Sergei V Sergiyko, Mikhail K. Ivanov, S. E. Titov, P. S. Demenkov |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Thyroid nodules medicine.medical_specialty Cytodiagnosis Biopsy Fine-Needle Thyroid Gland 030209 endocrinology & metabolism Real-Time Polymerase Chain Reaction Malignancy Sensitivity and Specificity Pathology and Forensic Medicine Diagnosis Differential 03 medical and health sciences 0302 clinical medicine Fine needle aspiration cytology Neoplasms Cytology medicine Humans RNA Messenger Thyroid Neoplasms Thyroid Nodule Thyroid cancer Aged business.industry HMGA2 Protein General Medicine Middle Aged medicine.disease Predictive value MicroRNAs 030220 oncology & carcinogenesis Preoperative Period Feasibility Studies Female Radiology Differential diagnosis business Indeterminate Algorithms |
| Zdroj: | Journal of Clinical Pathology. 73:722-727 |
| ISSN: | 1472-4146 0021-9746 |
| Popis: | AimsAnalysis of molecular markers in addition to cytological analysis of fine-needle aspiration (FNA) samples is a promising way to improve the preoperative diagnosis of thyroid nodules. Previously, we have developed an algorithm for the differential diagnosis of thyroid nodules by means of a small set of molecular markers. Here, we aimed to validate this approach using FNA cytology samples of Bethesda categories III and IV, in which preoperative detection of malignancy by cytological analysis is impossible.MethodsA total of 122 FNA smears from patients with indeterminate cytology (Bethesda III: 13 patients, Bethesda IV: 109 patients) were analysed by real-time PCR regarding the preselected set of molecular markers (the BRAF V600E mutation, normalised concentrations of HMGA2 mRNA, 3 microRNAs, and the mitochondrial/nuclear DNA ratio). The decision tree–based classifier was used to discriminate between benign and malignant tumours.ResultsThe molecular testing detected malignancy in FNA smears of indeterminate cytology with 89.2% sensitivity, 84.6% positive predictive value, 92.9% specificity and 95.2% negative predictive value; these characteristics are comparable with those of more complicated commercial tests. Residual risk of malignancy for the thyroid nodules that were shown to be benign by this molecular method did not exceed the reported risk of malignancy for Bethesda II histological diagnosis. Analytical-accuracy assessment revealed required nucleic-acid input of ≥5 ng.ConclusionsThe study shows feasibility of preoperative differential diagnosis of thyroid nodules of indeterminate cytology using a small panel of molecular markers of different types by a simple PCR-based method using stained FNA smears. |
| Databáze: | OpenAIRE |
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