Preoperative Molecular Markers in Thyroid Nodules
The need for distinguishing benign from malignant thyroid nodules has led to the pursuit of differentiating molecular markers. The most common molecular tests in clinical use are Afirma® Gene Expression Classifier (GEC) and Thyroseq® V2. Despite the rapidly developing field of molecular markers, sev...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2018-04-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fendo.2018.00179/full |
| _version_ | 1818944211204964352 |
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| author | Zeyad T. Sahli Philip W. Smith Christopher B. Umbricht Martha A. Zeiger |
| author_facet | Zeyad T. Sahli Philip W. Smith Christopher B. Umbricht Martha A. Zeiger |
| author_sort | Zeyad T. Sahli |
| collection | DOAJ |
| description | The need for distinguishing benign from malignant thyroid nodules has led to the pursuit of differentiating molecular markers. The most common molecular tests in clinical use are Afirma® Gene Expression Classifier (GEC) and Thyroseq® V2. Despite the rapidly developing field of molecular markers, several limitations exist. These challenges include the recent introduction of the histopathological diagnosis “Non-Invasive Follicular Thyroid neoplasm with Papillary-like nuclear features”, the correlation of genetic mutations within both benign and malignant pathologic diagnoses, the lack of follow-up of molecular marker negative nodules, and the cost-effectiveness of molecular markers. In this manuscript, we review the current published literature surrounding the diagnostic value of Afirma® GEC and Thyroseq® V2. Among Afirma® GEC studies, sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) ranged from 75 to 100%, 5 to 53%, 13 to 100%, and 20 to 100%, respectively. Among Thyroseq® V2 studies, Se, Sp, PPV, and NPV ranged from 40 to 100%, 56 to 93%, 13 to 90%, and 48 to 97%, respectively. We also discuss current challenges to Afirma® GEC and Thyroseq® V2 utility and clinical application, and preview the future directions of these rapidly developing technologies. |
| first_indexed | 2024-12-20T07:39:37Z |
| format | Article |
| id | doaj.art-592607abbf3447f9915e48fe2dddea9f |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-20T07:39:37Z |
| publishDate | 2018-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-592607abbf3447f9915e48fe2dddea9f2022-12-21T19:48:10ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922018-04-01910.3389/fendo.2018.00179364213Preoperative Molecular Markers in Thyroid NodulesZeyad T. Sahli0Philip W. Smith1Christopher B. Umbricht2Martha A. Zeiger3Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, United StatesDepartment of Surgery, University of Virginia, Charlottesville, VA, United StatesDepartment of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, United StatesDepartment of Surgery, University of Virginia, Charlottesville, VA, United StatesThe need for distinguishing benign from malignant thyroid nodules has led to the pursuit of differentiating molecular markers. The most common molecular tests in clinical use are Afirma® Gene Expression Classifier (GEC) and Thyroseq® V2. Despite the rapidly developing field of molecular markers, several limitations exist. These challenges include the recent introduction of the histopathological diagnosis “Non-Invasive Follicular Thyroid neoplasm with Papillary-like nuclear features”, the correlation of genetic mutations within both benign and malignant pathologic diagnoses, the lack of follow-up of molecular marker negative nodules, and the cost-effectiveness of molecular markers. In this manuscript, we review the current published literature surrounding the diagnostic value of Afirma® GEC and Thyroseq® V2. Among Afirma® GEC studies, sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV) ranged from 75 to 100%, 5 to 53%, 13 to 100%, and 20 to 100%, respectively. Among Thyroseq® V2 studies, Se, Sp, PPV, and NPV ranged from 40 to 100%, 56 to 93%, 13 to 90%, and 48 to 97%, respectively. We also discuss current challenges to Afirma® GEC and Thyroseq® V2 utility and clinical application, and preview the future directions of these rapidly developing technologies.http://journal.frontiersin.org/article/10.3389/fendo.2018.00179/fullthyroid cancernon-invasive follicular thyroid neoplasm with papillary-like nuclear featuresmolecular testAfirmaThyroseq |
| spellingShingle | Zeyad T. Sahli Philip W. Smith Christopher B. Umbricht Martha A. Zeiger Preoperative Molecular Markers in Thyroid Nodules Frontiers in Endocrinology thyroid cancer non-invasive follicular thyroid neoplasm with papillary-like nuclear features molecular test Afirma Thyroseq |
| title | Preoperative Molecular Markers in Thyroid Nodules |
| title_full | Preoperative Molecular Markers in Thyroid Nodules |
| title_fullStr | Preoperative Molecular Markers in Thyroid Nodules |
| title_full_unstemmed | Preoperative Molecular Markers in Thyroid Nodules |
| title_short | Preoperative Molecular Markers in Thyroid Nodules |
| title_sort | preoperative molecular markers in thyroid nodules |
| topic | thyroid cancer non-invasive follicular thyroid neoplasm with papillary-like nuclear features molecular test Afirma Thyroseq |
| url | http://journal.frontiersin.org/article/10.3389/fendo.2018.00179/full |
| work_keys_str_mv | AT zeyadtsahli preoperativemolecularmarkersinthyroidnodules AT philipwsmith preoperativemolecularmarkersinthyroidnodules AT christopherbumbricht preoperativemolecularmarkersinthyroidnodules AT marthaazeiger preoperativemolecularmarkersinthyroidnodules |