European perspective on the use of molecular tests in the diagnosis and therapy of thyroid neoplasms

Oczko‐Wojciechowska, Małgorzata; Kotecka-Blicharz, Agnieszka; Krajewska, Jolanta; Rusinek, Dagmara; Barczyński, Marcin; Jarząb, Barbara; Czarniecka, Agnieszka

doi:10.21037/gs.2019.10.26

Cited by 16 publications

(13 citation statements)

References 52 publications

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“…In Wei's study, authors got a conclusion that miRNAs have sensitivity of 0.75 and specificity of 0.81 in discriminating malignant thyroid nodules from benign ones on 361 FNAB samples 20 . In Zhou's study, authors evaluated the diagnostic accuracy of microRNAs in distinguishing malignant thyroid lesions from benign ones in 266 FNAB samples with sensitivity of 0.78 and specificity of 0.73 21 . Besides this, a meta‐analysis conducted by Stokowy pointed out that miR‐7‐5p as a universal miRNA differentiating malignant and benign thyroid tumours 22 .…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of circulating microRNAs in thyroid carcinoma: A systematic review and meta‐analysis

Tian

Zhou

et al. 2020

Clinical Endocrinology

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Background and objective Thyroid cancer (TC) is the most common endocrine system tumour. Several studies had revealed the potential of circulating microRNAs (miRNAs) as novel biomarkers for the diagnosis of TC. The purpose of this meta‐analysis is to summarize published studies and evaluate the diagnostic accuracy of circulating miRNAs in TC detection. Methods In this meta‐analysis, we systematically searched three databases: PubMed, EMBASE and Cochrane Library. We used the bivariate mixed‐effects regression model to calculate the pooled diagnostic parameters and conduct the summary receiver operator characteristic curve (SROC). All calculations were performed using stata software. Results Thirty‐five studies from 9 articles, including 663 TC patients, 519 patients with benign thyroid nodules (BTNs), and 84 healthy controls were included in this meta‐analysis. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and area under the SROC curve (AUC) were 0.81 (95% CI 0.75‐0.86), 0.81 (95% CI 0.75‐0.86), 4.3 (95% CI 3.2‐5.6), 0.24 (95% CI 0.18‐0.31), 18 (95% CI 12‐28) and 0.88 (95% CI 0.85‐0.90), respectively in BTN controls, and 0.81 (95% CI 0.75‐0.86), 0.85 (95% CI 0.75‐0.91), 5.3 (95% CI 3.3‐8.7), 0.23 (95% CI 0.18‐0.29), 24 (95% CI 14‐39), 0.89 (95% CI 0.86‐0.91) in healthy controls. The subgroup analysis found that multiple miRNA assays had higher diagnostic accuracy than single miRNA assays with sensitivity of 0.88, specificity of 0.89 and AUC of 0.94. Conclusion Circulating miRNAs have good values to diagnose TC and distinguish TC patients from BTN patients. MiRNAs can assist in the diagnosis of malignancy and avoid unnecessary surgery. In summary, circulating miRNAs should be added to our current clinical tools.

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Section: Discussionmentioning

confidence: 99%

Diagnostic value of circulating microRNAs in thyroid carcinoma: A systematic review and meta‐analysis

Tian

Zhou

et al. 2020

Clinical Endocrinology

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“…According to Celik M, et al report, the molecular assessment during FNA may have also potential to be valuable in diagnostic workup of thyroid tumors with uncertain malignant potential [36]. Unfortunately, the molecular tests currently commercially available were developed and mostly validated in the United States population, which apart from the price ($2,000 to $5,000), limits their application in Polish clinical practice, due to significant differences in the malignancy risk in indeterminate thyroid nodules in the Polish population [37]. Moreover, meta-analysis of Borowczyk M, et al points out some limitations in performance of available molecular tests [38].…”

Section: Discussionmentioning

confidence: 99%

Thyroid nodules with indeterminate cytopathology: a constant challenge in everyday practice. The effectiveness of clinical decisions using diagnostic tools available in Poland

Kotecka-Blicharz¹,

Pfeifer²,

Czarniecka³

et al. 2021

Polish Archives of Internal Medicine

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The study proves a low malignancy risk in Bethesda category III and IV thyroid nodules in the Polish population -6.7% and 11.3%, respectively. Universal referral for surgery of these indeterminate thyroid nodules leads to overtreatment, with patients unjustifiably being exposed to possible life-long complications. A concurrent analysis of the clinical risk factors and a thyroid nodule ultrasound pattern may be not sufficiently effective in refining the malignancy risk in thyroid nodule after obtaining an indeterminate cytopathology result. The analysis points to the urgent need for new tools to be created for the Polish population in the management of thyroid nodules with an indeterminate cytopathology result, in order to minimize the number of redundant thyroid surgical procedures, as well as to optimally determine the extent of the primary surgical procedure, if necessary.

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“…Continuous progress in technologies that allow simultaneous testing of multiple genes results in lower molecular testing costs and an increased number of studies on molecular markers. A recently published paper related to TC raises the role of molecular classifiers [3]. At the same time, the supportive role of clinical data is underestimated.…”

Section: Introductionmentioning

confidence: 99%

Bayesian Assessment of Diagnostic Strategy for a Thyroid Nodule Involving a Combination of Clinical Synthetic Features and Molecular Data

et al. 2020

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The use of machine learning has increased over the years, especially in the world of molecular data. Generally, the inference of relationships between features is determined by statistical models. The phenotype (observable clinical characteristics) can result from the expression of the genotype (genetic code) or environmental factors. Molecular datasets have limited information, while supporting clinical data is ambiguous. There are no well-established approaches for combining clinical information with genomic repositories. The genomic tests that are available only use molecular data and give physicians a result which can be integrated clinically. In this paper, we present the strategy where clinical data, regardless of its limitations, is combined in one predictive model with molecular features. We predict the risk of malignancy in the thyroid nodules based on the results of fine-needle aspiration biopsy and expression of selected genes. We utilize a Bayesian network (BN) framework to discover relationships between molecular features and assess the impact of added clinical data quality on the performance of the chosen gene set. Bayesian network offering both prognostic and diagnostic perspectives is a perfect non-parametric technique for feature selection, feature extraction, and prediction purposes. We show that certain clinical factors could work as a synthetic feature and provide predictive abilities beyond what genes alone can offer. The experimental results demonstrate a higher performance of predictive models based on molecular and clinical data than when using only molecular data. We also explain why, one should consider the source of clinical data, but be aware of the quality of variables.

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European perspective on the use of molecular tests in the diagnosis and therapy of thyroid neoplasms

Cited by 16 publications

References 52 publications

Diagnostic value of circulating microRNAs in thyroid carcinoma: A systematic review and meta‐analysis

Diagnostic value of circulating microRNAs in thyroid carcinoma: A systematic review and meta‐analysis

Thyroid nodules with indeterminate cytopathology: a constant challenge in everyday practice. The effectiveness of clinical decisions using diagnostic tools available in Poland

Bayesian Assessment of Diagnostic Strategy for a Thyroid Nodule Involving a Combination of Clinical Synthetic Features and Molecular Data

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