Surgical Results of Thyroid Nodules according to a Management Guideline Based on the BRAFV600E Mutation Status

Kim, Suk Kyeong; Hwang, Tae Sook; Yoo, Young Bum; Han, Hye Seung; Kim, Dong-Lim; Song, Kee‐Ho; Lim, So Duk; Kim, Wan Seop; Paik, Nam Sun

doi:10.1210/jc.2010-1082

Cited by 129 publications

(149 citation statements)

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“…5,6,8,9,[12][13][14] The data from these series are summarized in Table 1. It is interesting to note that the overall rate of AUS was 9.7% with only 2 of 8 series reporting AUS rates below the previously recommended threshold of 7%.…”

Section: Resultsmentioning

confidence: 99%

“…We identified PubMed-indexed, peer-reviewed published laboratory experiences using TBS in which the categorical breakdown of all 6 reporting tiers was identified 5,6,8,9,[12][13][14] and supplemented those data with previously unpublished figures from the Massachusetts General Hospital compiled by one of the authors (W.C.F.) from 2006 to 2008 using TBS (a subset of these cases was included in a prior study 3 ).…”

Section: Methodsmentioning

confidence: 99%

“…The heterogeneity of this low-risk category inevitably means that there will be differences in its utilization with significant variability in AUS rates noted among individual practitioners as well as between laboratories. [2][3][4][5][6][7][8][9][10][11][12][13][14] Indeed, TBS only recommends a broad use range for each diagnostic category. 1 To promote uniform practice among laboratories and cytopathologists and encourage quality improvement, it is desirable to have performance measures associated with TBS, especially with regard to the AUS category.…”

Section: Introductionmentioning

confidence: 99%

“…15 The only such recommendation that accompanied TBS for thyroid cytopathology was that the AUS rate not exceed 7% 1 ; however, this proposal lacked a robust evidentiary basis and has proved to be unrealistic for many laboratories publishing their initial experiences with TBS. [2][3][4][5][6][7][8][9][10][11][12][13][14] In this study, we review the initial published experiences with AUS and TBS in conjunction with our own laboratory experiences, with the goal of identifying evidencebased performance measures that will have usefulness in measuring individual and laboratory practices. In so doing, we hope to provide a basis for quality improvement in the reporting of thyroid aspirates within TBS framework.…”

Section: Introductionmentioning

confidence: 99%

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The atypia of undetermined significance/follicular lesion of undetermined significance:malignant ratio

Krane

VanderLaan

Faquin

et al. 2011

Cancer Cytopathology

123

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BACKGROUND:The Bethesda System (TBS) for reporting thyroid cytopathology introduced the atypia of undetermined significance/follicular lesion of undetermined significance (AUS) category, but did not provide adequate guidance for the appropriate use of this diagnosis. In the current study, the authors sought to identify an appropriate measure for AUS use based on experience to date with TBS.METHODS:The authors reviewed 8 series, including their own laboratory experiences, with a total of 30,466 thyroid aspirates classified within TBS.RESULTS:The median AUS rate was 9.9% with a range of 3.0% to 18.0%. Use of the individual diagnostic categories within TBS varied up to 12.7‐fold. The ratio of “suspicious for follicular neoplasm” plus “suspicious for malignancy” to “malignant” (M) diagnoses varied the least (1.8‐fold). The AUS:M ratio provided a suitable measure of assessing AUS use, with a median ratio of 2.0 and a range of 0.5 to 4.9.CONCLUSIONS:Based on available studies, an AUS:M ratio of 1.0 to 3.0 is recommended. AUS:M ratios > 3.0 are likely because of overdiagnosis of AUS or underdiagnosis of M. AUS:M ratios < 1.0 are mostly due to low AUS rates, at the likely expense of sensitivity. Cancer (Cancer Cytopathol) 2012;. © 2011 American Cancer Society.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The atypia of undetermined significance/follicular lesion of undetermined significance:malignant ratio

Krane

VanderLaan

Faquin

et al. 2011

Cancer Cytopathology

123

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“…Recent studies reported that the BRAF mutation is a highly accurate marker of malignancy for thyroid nodules sampled by FNAB [205][206][207][208][209]. However, the most frequent diagnostic problems in FNAB samples are indeterminate follicular tumors and suspicion of malignancy according to the Bethesda system.…”

Section: Molecular Targets In Histopathological Diagnosis and Classifmentioning

confidence: 99%

An update on molecular biology of thyroid cancers

Ömür

Baran

2014

Critical Reviews in Oncology/Hematology

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BRAF^V600E mutation analysis in fine‐needle aspiration cytology specimens for diagnosis of thyroid nodules: The influence of false‐positive and false‐negative results

et al. 2019

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Background The accurate evaluation of BRAFV600E mutation in preoperative fine‐needle aspiration cytology (FNAC) specimens is important for making management decisions in thyroid nodules (TNs). The aim of this study was to assess the false‐positive and false‐negative BRAFV600E mutations in thyroid FNAC specimens and their influence on diagnosis of TN. Methods This prospective study enrolled 292 nodules in 269 patients who underwent BRAFV600E mutation analysis using amplification refractory mutation system‐quantitative real‐time polymerase chain reaction (ARMS‐qPCR) both in FNAC specimens and formalin‐fixed, paraffin‐embedded (FFPE) tissue samples after surgery. The false‐positive and false‐negative mutations for BRAFV600E analysis using ARMS‐qPCR in FNAC specimens were recorded, with reference to the results of BRAFV600E mutation analysis using ARMS‐qPCR in FFPE tissue sample. Diagnostic performances of FNAC, BRAFV600E mutation analysis in FNAC specimens, BRAFV600E mutation analysis in FFPE tissue sample, and the combination of FNAC and BRAFV600E mutation analysis for predicting thyroid malignancy were assessed. Results The false‐positive and false‐negative mutations for BRAFV600E analysis using ARMS‐qPCR in FNAC specimens were 10.1% (19/189) and 7.1% (7/98), respectively. FNAC combined with preoperative BRAFV600E mutation analysis significantly increased the diagnostic sensitivity from 75.7% to 92.3%, and accuracy from 78.7% to 90.6% in comparison with FNAC alone (both P < .001). No significant differences were found between the combination of FNAC and BRAFV600E mutation analysis in FNAC specimens and the combination of FNAC and BRAFV600E mutation analysis in FFPE tissue sample (sensitivity: 92.3% vs 91.9%; accuracy: 90.6% vs 91.3%; both P > .05). Conclusions FNAC combined with preoperative BRAFV600E mutation analysis can significantly increase the diagnostic performance in comparison with FNAC alone. False‐positive and false‐negative BRAFV600E mutation results are found in preoperative FNAC specimens, whereas it does not affect the overall auxiliary diagnosis of TNs.

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Surgical Results of Thyroid Nodules according to a Management Guideline Based on the BRAFV600E Mutation Status

Abstract: We found that performing BRAF(V600E) mutation analysis on the fine-needle aspiration biopsy specimens was of great help to make a therapeutic decision for thyroid nodules when the fine-needle aspiration biopsy results were equivocal.

Cited by 129 publications

References 20 publications

The atypia of undetermined significance/follicular lesion of undetermined significance:malignant ratio

The atypia of undetermined significance/follicular lesion of undetermined significance:malignant ratio

An update on molecular biology of thyroid cancers

BRAF^V600E mutation analysis in fine‐needle aspiration cytology specimens for diagnosis of thyroid nodules: The influence of false‐positive and false‐negative results

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Surgical Results of Thyroid Nodules according to a Management Guideline Based on the BRAFV600E Mutation Status

Abstract: We found that performing BRAF(V600E) mutation analysis on the fine-needle aspiration biopsy specimens was of great help to make a therapeutic decision for thyroid nodules when the fine-needle aspiration biopsy results were equivocal.

Cited by 129 publications

References 20 publications

The atypia of undetermined significance/follicular lesion of undetermined significance:malignant ratio

The atypia of undetermined significance/follicular lesion of undetermined significance:malignant ratio

An update on molecular biology of thyroid cancers

BRAFV600E mutation analysis in fine‐needle aspiration cytology specimens for diagnosis of thyroid nodules: The influence of false‐positive and false‐negative results

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Product

Resources

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BRAF^V600E mutation analysis in fine‐needle aspiration cytology specimens for diagnosis of thyroid nodules: The influence of false‐positive and false‐negative results