&lt;i&gt;BRAF&lt;/i&gt; Mutation Testing of Thyroid Fine-Needle Aspiration Specimens Enhances the Predictability of Malignancy in Thyroid Follicular Lesions of Undetermined Significance

Adeniran, Adebowale; Hui, Pei; Chhieng, David C.; Prasad, Manju L.; Schofield, Kevin; Theoharis, Constantine

doi:10.1159/000333274

Cited by 67 publications

(47 citation statements)

References 42 publications

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“…This can be connected with the low prevalence of PTC in this cytological category and higher prevalence of FTC that are BRAF V600E negative. Moreover, in all the studies it was highlighted that high positive predictive value in the detection of cancer can reach 100% [25][26][27]. Results from the presented study are concordant with cited reports.…”

Section: Discussionsupporting

confidence: 89%

Przydatność określania obecności mutacji BRAF V600E w biopsji aspiracyjnej celowanej cienkoigłowej w zmianach niezdeterminowanych

Kowalska

Kowalik

Pałyga

et al. 2016

Endokrynologia Polska

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Introduction: Fine-needle aspiration biopsy (FNAB) is regarded as the gold standard method for the diagnosis of thyroid nodules, but it has its limitations. Additional methods that would improve sensitivity and specificity in the diagnosis of thyroid cancer (TC), especially in indeterminate lesions. Molecular tests seem to be such a tool. BRAF V600E mutation (the most common in TC) can be detected in FNAB and can be potentially a very useful ancillary marker for FNAB practice. The aim of our study was to evaluate the usefulness of the detection of the BRAF V600E mutation in FNAC in the early diagnosis of TC in patients with indeterminate cytology. Material and method: 2290 FNAB were performed and 147 indeterminate results (group 3, 4, and 5 of the Bethesda system) were obtained. Material from these groups was submitted for molecular tests for the occurrence of BRAF V600E mutation. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the tests were calculated. Results: Determining the presence of BRAF V600E mutation in FNAC material in groups 3 and 4 together and in group 5 is associated with sensitivity of TC diagnosis of 37.5% and 81.8%, respectively. In all cases the detection of BRAF V600E mutation was associated with histopathologically proving the presence of TC (specificity of the test -100%). Conclusions:1. The presence of BRAF V600E mutation in FNAC material is always associated with the presence of TC. 2. The usefulness of determining the presence of BRAF V600E in FNAC in cytological groups 3 and 4 is associated with low sensitivity in the diagnosis of thyroid cancer. 3. Due to its high specificity BRAF V600E study may be useful in determining the scope of surgery in patients in cytological group 5. (Endokrynol Pol 2016; 67 (1): 41-47)

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Section: Discussionsupporting

confidence: 89%

Przydatność określania obecności mutacji BRAF V600E w biopsji aspiracyjnej celowanej cienkoigłowej w zmianach niezdeterminowanych

Kowalska

Kowalik

Pałyga

et al. 2016

Endokrynologia Polska

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“…8 Adeniran et al 1 suggested that BRAF mutation testing can be used with high specificity to predict malignancy in thyroid follicular lesions of undetermined significance. Similarly, we showed that BRAF expression was significantly higher in our FVPC tissues.…”

Section: Discussionmentioning

confidence: 99%

“…However, in the FVPC, BRAF mutation was reported in only 5-20% of cases, 8 and there is limited study on the role of BRAF expression in differentiating between follicular lesions of thyroid. 1,4 GAL-3 is a beta-galactosylbinding lectin which is involved in regulating cell-cell and cellmatrix interactions. Galectin-3 expression has been proposed to be a reliable molecular marker of FC 9 and PC, 10 and suggested be used to differentiate benign from malignant thyroid nodules.…”

Section: Introductionmentioning

confidence: 99%

Thyroid Tumors with Encapsulated Follicular Pattern : A Diagnostıc Dilemma

Arpacı

Kara

Didar

et al. 2017

ACP

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We aimed to determine the immunoreactivity for B-type Raf kinase (BRAF), , Hector Battifora mesothelial-1 (HBME-1), and Galectin-3 (GAL-3) antibodies in single and combination forms to define their potential role on diagnosis in encapsulated follicular thyroid tumors creating diagnostic difficulties. One hundred thirty five thyroid tumors diagnosed with follicular adenoma (FA, n=50), encapsulated minimally invasive follicular carcinoma (MIFC, n=40), and encapsulated follicular variant of papillary carcinoma (FVPC, n=45) were evaluated for immunohistochemically. For a single antibody, HBME-1 was the most sensitive antibody for the diagnosis of FVPC vs FA (93,33%), whereas CK-19 had the lowest sensitivity among the 4 markers. HBME-1 + GAL-3 combination has the most sensitivity value (67,5%) for diagnosing MIFC vs FA. The combination of CK19+HBME1+GAL3 and CK19+HBME1+BRAF have the highest sensitivity values (62,5%) for diagnosing FK vs FA. The coexpression of the four antibodies showed average sensitivity and high specificity results as 60-65% in sensitivity and 80% in spesifity for MIFC vs FA; FVPC vs FA and FVPC vs MIFC. For optimum sensitivity and specificity, the combination of the four markers was suggested for the diagnosis of MIFC vs FA. In conclusion, immunohistochemical evaluation of BRAF, CK-19, HBME-1 and GAL-3 in tyhroid tumors would aid the differentiation of malignant follicular lesions from benign follicular lesion. Combination of different forms of antibodies in accordance with the lesion type to be distinguished may increase the sensitivity of diagnosis, which needs to be confirmed with further studies.

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“…In order to overcome these discrepancies in terms of choice of methodology, there are additional studies that suggest that analysis at a molecular level provides almost the same results as with a second TFNAB (2,14). A view that has recently gained momentum is a consensus approach mentioned by Jing and colleagues (15).…”

Section: Discussionmentioning

confidence: 99%

Should We Determine the Significance of “Follicular Lesion of Undetermined Significance’’

Ay¹

2013

CMR

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Abstract:Aim: Thyroid fine-needle aspiration biopsy (TFNAB) is the gold standard methodology for the evaluation of thyroid nodule. Nevertheless, diagnosis of TFNAB specimens is sometimes interpreted as "follicular lesion of undetermined significance": This indeterminate diagnosis is given upon TFNAB despite the presence of sufficient cellular material available for cytopathological analysis. Furthermore, this indeterminate diagnosis constitutes a grey zone between benign lesion and malignancy. As a result, it becomes difficult to determine the type of surgical intervention that needs to be performed on the patient and the technique that will be used. In this study, we aim to correlate the diagnosis of "follicular lesion of undetermined significance" with clinical and postoperative evaluations. Methods: A total of 147 patients, who were diagnosed as "follicular lesion of undetermined significance" following initial TFNAB, were included in this retrospective study. These patients were evaluated according to whether they underwent a second TFNAB or thyroidectomy pathology following initial diagnosis of "follicular lesion of undetermined significance". Results: Results were generated by evaluating the reports of the second TFNAB and 15 of 147 patients were followed. Histopathological examination of specimens derived from 132 patients following surgery revealed the following diagnosis: (i) hyperplasia in 67 patients, (ii) nodular lesion belonging to Hashimoto's thyroiditis in 34 patients, (iii) papillary carcinoma in 28 patients, (iv) follicular carcinoma in two patients, and (v) anaplastic carcinoma in one patient. Conclusion: Based on this retrospective study and on examination of the available literature concerning the treatment options and follow-up of patients initially diagnosed as "follicular lesion of undetermined significance" (FLUS or Atypia of undetermined significance) upon TFNAB, we conclude that it is important to keep in mind the elevated rates of malignancy that potentially develop from these undetermined lesions. is electronic document is a "live" template. The various components of your paper [title, text, heads, etc.] are already defined on the style sheet, as illustrated by the portions given in this document.

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<i>BRAF</i> Mutation Testing of Thyroid Fine-Needle Aspiration Specimens Enhances the Predictability of Malignancy in Thyroid Follicular Lesions of Undetermined Significance

Cited by 67 publications

References 42 publications

Przydatność określania obecności mutacji BRAF V600E w biopsji aspiracyjnej celowanej cienkoigłowej w zmianach niezdeterminowanych

Przydatność określania obecności mutacji BRAF V600E w biopsji aspiracyjnej celowanej cienkoigłowej w zmianach niezdeterminowanych

Thyroid Tumors with Encapsulated Follicular Pattern : A Diagnostıc Dilemma

Should We Determine the Significance of “Follicular Lesion of Undetermined Significance’’

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