Fine needle aspiration cytology in cancer diagnosis

Roskell, Derek; Buley, I

doi:10.1136/bmj.329.7460.244

Cited by 39 publications

(40 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A consistent reporting framework using triple assessment is well established as a valuable tool in preoperative breast cancer diagnosis [Boerner and Sneige, 1998;Roskell and Buley, 2004;Farshid and Downey, 2005]. Following triple assessment of a breast lesion, the most suspicious category prevails in planning further management.…”

Section: Breast Cancer Triple Assessment By Clinical Examination Imamentioning

confidence: 99%

Sequence variant classification and reporting: recommendations for improving the interpretation of cancer susceptibility genetic test results

et al. 2008

View full text Add to dashboard Cite

For the Mutation Pathogenicity Special IssueGenetic testing of cancer susceptibility genes is now widely applied in clinical practice to predict risk of developing cancer. In general, sequence-based testing of germline DNA is used to determine whether an individual carries a change that is clearly likely to disrupt normal gene function. Genetic testing may detect changes that are clearly pathogenic, clearly neutral, or variants of unclear clinical significance. Such variants present a considerable challenge to the diagnostic laboratory and the receiving clinician in terms of interpretation and clear presentation of the implications of the result to the patient. There does not appear to be a consistent approach to interpreting and reporting the clinical significance of variants either among genes or among laboratories. The potential for confusion among clinicians and patients is considerable and misinterpretation may lead to inappropriate clinical consequences. In this article we review the current state of sequence-based genetic testing, describe other standardized reporting systems used in oncology, and propose a standardized classification system for application to sequence-based results for cancer predisposition genes. We suggest a system of five classes of variants based on the degree of likelihood of pathogenicity. Each class is associated with specific recommendations for clinical management of at-risk relatives that will depend on the syndrome. We propose that panels of experts on each cancer predisposition syndrome facilitate the classification scheme and designate appropriate surveillance and cancer management guidelines. GENETIC TESTING FOR CANCER SUSCEPTIBILITYClinical testing is currently available for more than 1,500 different genes or genetic conditions (www.genetests.org). The initial DNA-based tests introduced by clinically-certified genetic testing laboratories focused on identification of previously defined mutations in relatively rare genetic disorders. For example, molecular testing for cystic fibrosis and for multiple endocrine neoplasia type 2 (MEN2) was based on panels of known mutations in the CFTR (MIM] 602421) and RET (MIM] 164761) genes, respectively. Genetic tests based on sequencing of the entire coding region were not generally used clinically because of the expense involved in sequencing, the lack of sequence/polymorphism information, as well as the need to improve methodologies to efficiently interpret the sequence traces.

show abstract

Section: Breast Cancer Triple Assessment By Clinical Examination Imamentioning

confidence: 99%

Sequence variant classification and reporting: recommendations for improving the interpretation of cancer susceptibility genetic test results

et al. 2008

View full text Add to dashboard Cite

show abstract

“…This was achieved by developing (i) new magnetic nanoparticles with high transverse relaxivity, (ii) a NMR probe with improved signal-to-noise ratio (SNR), and (iii) an analytical DMR protocol that can quantify the expression level of molecular markers in tumor cells. The clinical utility of the system (DMR-2) was evaluated by using FNA (14,15) from a panel of xenograft tumor models. We detected as few as 2 cells in 1-L volumes and analyzed cells for growth factor expression in nonpurified samples.…”

mentioning

confidence: 99%

Rapid detection and profiling of cancer cells in fine-needle aspirates

Lee

Yoon²,

Figueiredo³

et al. 2009

Proc. Natl. Acad. Sci. U.S.A.

176

210

View full text Add to dashboard Cite

There is a growing need for fast, highly sensitive and quantitative technologies to detect and profile unaltered cells in biological samples. Technologies in current clinical use are often time consuming, expensive, or require considerable sample sizes. Here, we report a diagnostic magnetic resonance (DMR) sensor that combines a miniaturized NMR probe with targeted magnetic nanoparticles for detection and molecular profiling of cancer cells. The sensor measures the transverse relaxation rate of water molecules in biological samples in which target cells of interest are labeled with magnetic nanoparticles. We achieved remarkable sensitivity improvements over our prior DMR prototypes by synthesizing new nanoparticles with higher transverse relaxivity and by optimizing assay protocols. We detected as few as 2 cancer cells in 1-L sample volumes of unprocessed fine-needle aspirates of tumors and profiled the expression of several cellular markers in <15 min.microfluidics ͉ nanoparticle ͉ nuclear magnetic resonance S ensitive and quantitative technologies for molecular characterization of scant cells in easily accessible bodily sources (e.g., fine-needle aspirates (FNA), biopsies, whole blood, and other biological fluids) will have significant impact in life sciences and clinical practice (1, 2). If made available, such diagnostic platforms could be used for early detection/screening of cancer, comprehensive tumor characterization in patients, and targeted therapy based on personal responses to treatments (3, 4). The ideal detection technology would combine minimal sample processing with fast measurements, thus avoiding likely phenotypic/apoptotic changes of sampled cells. It would also allow for multiple biomarker detection in a single parent sample (multichannel detection) for accurate diagnosis (5). A number of sensors fulfilling some of these criteria have been developed based on optical (6, 7), electronic (8, 9), or magnetic detection (10, 11). The clinical utility of these systems, however, is limited, because they require lengthy sample purification or long assay times.We recently developed a NMR-based sensor that offers fast detection of biological targets in native samples (12). Termed ''DMR'' for diagnostic magnetic resonance, the sensor measures the transverse relaxation rate (R 2 ) of water molecules in biological samples in which target molecules or cells of interest are labeled with magnetic nanoparticles (MNP).Local magnetic fields created by the MNP accelerate the spinspin relaxation of water protons, increasing the R 2 of samples (13) and thus providing a sensing mechanism. Because most biological objects have negligible magnetic susceptibilities, DMR measurements can be performed in unprocessed samples, allowing for fast assays. As proof-of-concept, we developed a prototype sensor (DMR-1) that detected bacteria, analytes, and abundant cancer cells (10 6 cells per mL) (12). Despite the underlying technological advantages, however, it has been difficult to achieve detection sensitivities (Ϸ10 3 cells p...

show abstract

“…6 Using fine needle aspiration cytology selectively when investigating thyroid nodules with suspicious ultrasound features can reduce the requirement for excision by at least 25% and doubles the yield of malignancy in those excised. 7 Although fine needle aspiration cytology is safe and easily performed without major complication, potential minor risks include local haemorrhage and inadvertent tracheal puncture, although these are rare. The procedure is contraindicated in patients who have a bleeding diathesis or who are unable to tolerate the procedure.…”

Section: Fine Needle Aspiration Cytologymentioning

confidence: 99%