Genetic testing for indeterminate thyroid cytology: review and meta-analysis
Autor: | Thomas Uslar, Soledad Urra, Natalia Mena, José Carlos de Miguel Domínguez, José R Martínez, Marcela Henríquez, Sergio Vargas-Salas, Hernán E. González, Marcela Lagos |
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Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Thyroid nodules
Cancer Research medicine.medical_specialty Endocrinology Diabetes and Metabolism media_common.quotation_subject Thyroid Gland 030209 endocrinology & metabolism Review molecular diagnostics 03 medical and health sciences 0302 clinical medicine Endocrinology medicine Humans Quality (business) Genetic Testing Thyroid Neoplasms Intensive care medicine Thyroid cancer indeterminate thyroid cytology Genetic testing media_common medicine.diagnostic_test accuracy business.industry Molecular diagnostics medicine.disease Precision medicine meta-analysis Oncology 030220 oncology & carcinogenesis Meta-analysis Indeterminate business |
Zdroj: | Endocrine-Related Cancer |
ISSN: | 1479-6821 1351-0088 |
Popis: | Thyroid cancer is the most frequent endocrine malignancy, and its incidence is increasing. A current limitation of cytological evaluation of thyroid nodules is that 20–25% are reported as indeterminate. Therefore, an important challenge for clinicians is to determine whether an indeterminate nodule is malignant, and should undergo surgery, or benign, and should be recommended to follow-up. The emergence of precision medicine has offered a valuable solution for this problem, with four tests currently available for the molecular diagnosis of indeterminate cytologies. However, efforts to critically analyze the quality of the accumulated evidence are scarce. This systematic review and meta-analysis is aimed to contribute to a better knowledge about the four available molecular tests, their technical characteristics, clinical performance, and ultimately to help clinicians to make better decisions to provide the best care options possible. For this purpose, we address three critical topics: (i) the proper theoretical accuracy, considering the intended clinical use of the test (rule-in vs rule-out) and the impact on clinical decisions; (ii) the quality of the evidence reported for each test (iii) and how accurate and effective have the tests proved to be after their clinical use. Together with the upcoming evidence, this work provides significant and useful information for healthcare system decision-makers to consider the use of molecular testing as a public health need, avoiding unnecessary surgical risks and costs. |
Databáze: | OpenAIRE |
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