Utility of Afirma Gene Expression Classifier for Evaluation of Indeterminate Thyroid Nodules and Correlation with Ultrasound Risk Assessment: Single Institutional Experience

Thyroseq v3, Afirma GSC, and microRNA Panels Versus Previous Molecular Tests in the Preoperative Diagnosis of Indeterminate Thyroid Nodules: A Systematic Review and Meta-Analysis

“…Among the articles that reported the number of TNs by TBSRTC, 4,501 (67.7%), 1,911 (28.7%), and 235 (3.5%) nodules were categories III, IV, and V, respectively. In nine papers, the patients were included after the second FNA that confirmed indeterminate cytology ( 50 – 52 , 54 , 58 , 59 , 69 , 70 , 72 ). Of the 7,831 TNs included, 240 (3.1%) have been proven to be non-diagnostic according to the molecular test result; therefore, we excluded them from the final analysis.…”

“…Regarding molecular panels, 25 studies evaluated the diagnostic performance of the Afirma GEC ( 8 , 16 , 17 , 40 , 47 – 54 , 56 – 58 , 61 , 63 , 64 , 66 – 70 , 72 , 76 , 77 ), and four articles reported the Afirma GSC ( 16 , 17 , 57 , 70 ). Thyroseq versions 2 and 3 were found in nine ( 11 , 15 , 58 , 59 , 61 , 62 , 71 , 73 , 75 ) and four papers ( 14 , 55 , 59 , 65 ), respectively, while ThyraMIR/ThyGenX ( 23 , 67 , 68 ) and ResettaGX Reveal ( 61 , 67 , 68 ) were explored in three studies, respectively.…”

“…The panels with the fewest assessments were ThyraMIR/ThyGeNEXT and miRInform ( 23 , 74 ). The majority of the studies (n = 32) evaluate a single molecular panel, of which 18 articles reported Afirma GEC alone ( 8 , 40 , 47 – 54 , 56 , 63 , 64 , 66 , 69 , 72 , 76 , 77 ), nine papers assessed second or third version of Thyroseq NGS ( 11 , 14 , 15 , 55 , 62 , 65 , 71 , 73 , 75 ) and lastly, ThyraMIR/ThyGeNEXT, ThyraMIR/ThyGenX, miRInform and RosettaGX Reveal were each approached in a study ( 21 , 23 , 60 , 74 ). Among the nine studies that measured up more that two molecular panels, four paper compared Afirma GEC and GSC ( 16 , 17 , 57 , 70 ), two manuscripts reported a comparison between Afirma GEC and Thyroseq v2 ( 58 , 61 ), two papers investigated the diagnostic performance of Afirma GEC, RosettaGX and Interpace MPT ( 67 , 68 ) and Jug et al.…”

“…Conversely, we found MTC and poorly differentiated thyroid cancer (PDTC) in seven cases each. Sixteen studies revealed 144 NIFTP cases after histological evaluation ( 14 , 17 , 23 , 40 , 49 , 51 , 56 – 59 , 61 , 62 , 65 , 67 , 72 , 73 , 75 ).…”

“…A total of 25 studies involving 4,538 cytologically ITNs of the 4,424 participants evaluated the Afirma GEC performance ( 8 , 17 , 40 , 47 – 54 , 56 – 58 , 61 , 63 , 64 , 66 – 70 , 72 , 76 , 77 ). The recruitment period ranged from May 2009 until June 2018.…”