PREDICTIVE VALUE OF SOMATIC MUTATIONS FOR THE DEVELOPMENT OF MALIGNANCY IN THYROID NODULES BY CYTOPATHOLOGY
| Autor: | Gábor Speer, Magdolna Dank, Csaba Halászlaki, János P. Kósa, Eszter Székely, Eszter Bölöny, Roland Istók, Tamás Székely, Balázs Járay, Zsuzsanna Putz, Bálint Tobiás, János Horányi, István Takács, Zsolt Nagy, Peter L. Lakatos, Bernadett Balla |
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| Rok vydání: | 2016 |
| Předmět: |
Thyroid nodules
Adult Male Pathology medicine.medical_specialty endocrine system diseases Adolescent Endocrinology Diabetes and Metabolism Cytodiagnosis Biopsy Fine-Needle DNA Mutational Analysis 030209 endocrinology & metabolism Real-Time Polymerase Chain Reaction Proto-Oncogene Mas 03 medical and health sciences Young Adult 0302 clinical medicine Endocrinology Germline mutation Predictive Value of Tests Biopsy Adenocarcinoma Follicular medicine Humans Thyroid Neoplasms Thyroid Nodule Thyroid cancer Aged Aged 80 and over medicine.diagnostic_test business.industry Carcinoma General Medicine Middle Aged medicine.disease Bethesda system for reporting thyroid cytopathology Carcinoma Papillary Cell Transformation Neoplastic Molecular Diagnostic Techniques Cytopathology Thyroid Cancer Papillary 030220 oncology & carcinogenesis Disease Progression Histopathology Female business PAX8 Follow-Up Studies |
| Zdroj: | Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 22(9) |
| ISSN: | 1530-891X |
| Popis: | The purpose of our prospective longitudinal study was to evaluate the predictive efficacy of genetic testing for malignancies in fine-needle aspiration biopsy samples that are cytologically benign at the time of biopsy.A total of 779 aspirated cytological samples collected from thyroid nodules of 626 patients were included in a 3-year follow-up study. Consecutive patients with cytologically benign thyroid nodules by the Bethesda System for Reporting Thyroid Cytopathology were enrolled in the study. At enrollment, somatic 1-point nucleotide polymorphisms of BRAF and RAS family genes were tested by melting-point analysis, while RET/PTC and PAX8/PPAR-gamma rearrangements were examined by real-time polymerase chain reaction. The genetic test was considered to be positive if a somatic mutation was found. Malignant cytopathologic diagnoses were confirmed by histopathology.In samples collected from 779 thyroid nodules, there were 39 BRAF, 33 RAS mutations, and 1 RET/PTC rearrangements found at the beginning of the study. No PAX8/PPAR-gamma rearrangement was identified. There were 52 malignant thyroid tumors removed during follow-up, out of which 24 contained a somatic mutation. The specificity of the presence of somatic mutations for malignancies was as high as 93.3%, and sensitivity was 46.2%. The negative predictive value of genetic testing reached 96.0%.Our results show that our set of genetic tests can predict the appearance of malignancy in benign thyroid nodules (at the beginning of follow-up) with high specificity and strong negative predictive value.BRAF = v-raf murine sarcoma viral oncogene homolog B1 FLUS = follicular lesion of undetermined significance FNAB = fine-needle aspiration biopsy FTC = follicular thyroid carcinoma HRAS = homologous to the oncogene from the Harvey rat sarcoma virus KRAS = homologous to the oncogene from the Kirsten rat sarcoma virus NRAS = first isolated from a human neuroblastoma/neuroblastoma RAS = viral oncogene homolog PAX8 = paired box 8 PCR = polymerase chain reaction PPAR-gamma = peroxisome proliferator-activated receptor gamma PTC = papillary thyroid carcinoma RAS = rat sarcoma RET = rearranged during transfection tyrosine-kinase proto-oncogene SM = somatic mutation SNP = single-nucleotide polymorphism. |
| Databáze: | OpenAIRE |
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