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Abstract

Design: In a retrospective study at Queens Hospital Center, medical records of 1010 patients with thyroid nodule over a five year period (Jan 2012-Dec 2016) was studied and rates of malignancy, molecular marker test (MMT) results, and number of cases of averted thyroidectomy were calculated. Results:Total of 151 patients were found to have indeterminate FNA cytology results; 85 patients had no MMTs, 38 had results from Thyroseqv2, and 28 had results from Afirma. Out of 85 patients with no MMT, 42 patients (49%) had a thyroidectomy which 9 (21%) had thyroid cancer and 33 (79%) had benign pathology. Seven patients with a positive Thyroseqv2 mutational panel had a thyroidectomy and of these, 5 (71%) were found malignant. 3 patients with negative Thyroseqv2 had a thyroidectomy due to nodule growth, and one had malignancy. With the use of Thyroseqv2, 22 patients out of 38 (57%) were spared unnecessary thyroidectomy. Of 28 patients who had Afirma results, 16(57%) had a suspicious gene expression classifier (GEC). Among 16 patients with a suspicious GEC, 11 had a thyroidectomy and 4 (36%) had cancer. GEC testing was able to spare 12 patients (42%) from thyroidectomy. Conclusions:Using MMTs, 34 (51%) patients out of 66 were spared unnecessary thyroidectomy. Due to a rather small sample size, statistical accuracy of MMTs has not been reported. Based on review of the literature, MMTs are very helpful in further analyzing indeterminate nodules and prevents unnecessary surgery given negative (both Thyroseqv2 and Afirma) and positive (Thyroseqv2) predictive values.