Impact of Molecular Testing on the Management of Indeterminate Thyroid Nodules Among Western and Asian Countries: a Systematic Review and Meta-analysis

Molecular Tests for Risk-Stratifying Cytologically Indeterminate Thyroid Nodules: An Overview of Commercially Available Testing Platforms in the United States

“…The molecular tests described in this review have primarily been validated and used in the United States. International differences in the application and impact of molecular testing for thyroid FNA samples have been reported and likely reflect contrasting management strategies for cytologically indeterminate nodules as well as differences in access to testing among different countries [25]. In our increasingly interconnected world, we expect that global discussions about our diverse risk-stratification approaches for thyroid nodules will help us move towards safer and more cost-effective care for patients worldwide.…”

“…Additionally, progress in understanding the molecular pathogenesis of thyroid neoplasms has fueled the development of molecular diagnostic tests for improving the preoperative risk-stratification of cytologically indeterminate thyroid nodules [24]. The primary goal of these molecular tests is to correctly identify benign nodules among those with indeterminate cytology, thereby decreasing the number of unnecessary diagnostic surgeries [25][26][27][28]. The updated versions of thyroid FNA classification schemes are now aligned with the aforementioned changes in histopathologic classification of thyroid neoplasms, applicability of molecular testing, and current recommendations for management.…”

Less is more meets do more with less: Exploring differences in thyroid FNA molecular testing between Asian and Western practices

“…describe, the less is more perspective that is characteristic of Asian practices extend to MT as well. For cytologically indeterminate nodules, Asian physicians appear to rely primarily on clinical and sonographic features (rather than MT) to determine whether immediate surgery is warranted 11 . For those Asian practices in which ancillary MT has been used, single‐gene testing for BRAF V600E (as opposed to complex multigene panels) predominates and has been proposed as a potentially cost‐effective complement to active surveillance 11 .…”

“…11 For those Asian practices in which ancillary MT has been used, single-gene testing for BRAF V600E (as opposed to complex multigene panels) predominates and has been proposed as a potentially cost-effective complement to active surveillance. 11 The higher prevalence of BRAF V600E mutation in papillary carcinomas reported in Asian studies likely informs this testing strategy. 12,13 The management differences that underlie these global variations in MT choice may be summarized as follows: In the context of thyroid nodule management, a lower tolerance for uncertainty has historically favored diagnostic surgery for clinically and/or cytologically indeterminate nodules in the United States.…”

Relationship between serum NDRG3 and papillary thyroid carcinoma

“…Molecular markers are expected to be used for early detection or screening of thyroid cancer, differentiation of benign and malignant diseases, histological identification, staging and treatment response, diagnosis and prognosis of recurrence ( 17 ). The American thyroid Association and the European thyroid Association have published guidelines recommending the detection of molecular markers for uncertain nodules ( 18 ). MYC is a human proto-oncogene, including C-MYC, N-MYC and L-MYC, involved in the occurrence, development, invasion and metastasis of tumors.…”