Thyroid Nodule
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New thyroid nodule study findings have been reported by scientists at University of Pittsburgh
2009 JUL 20 - (NewsRx.com) -- "Thyroid nodules are common in adults, but only a small fraction of them are malignant. Fine-needle aspiration (FNA) with cytological evaluation is the most reliable tool for cancer diagnosis in thyroid nodules," scientists in the United States report. "However, 10-40% of nodules are diagnosed as indeterminate by cytology, making it difficult to optimally manage these patients. The aim of this study was to establish the feasibility and role of testing for tumor-specific mutations in improving the FNA diagnosis of thyroid nodules. The prospective study included 470 FNA samples of thyroid nodules from 328 patients. At the time of aspiration, a small portion of the material was collected and tested for BRAF, RAS, RET/PTC, and PAX8/PPAR gamma mutations. The mutational status was correlated with cytology and either surgical pathology diagnosis or follow-up (mean, 34 months). A sufficient amount of nucleic acids were isolated in 98% of samples. Thirty-two mutations were found, including 18 BRAF, eight RAS, five RET/PTC, and one PAX8/PPAR gamma. The presence of any mutation was a strong indicator of cancer because 31 (97%) of mutation-positive nodules had a malignant diagnosis after surgery. A combination of cytology and molecular testing showed significant improvement in the diagnostic accuracy and allowed better prediction of malignancy in the nodules with indeterminate cytology. These results indicate that molecular testing of thyroid nodules for a panel of mutations can be effectively performed in a clinical setting," wrote Y.E. Nikiforov and colleagues, University of Pittsburgh. The researchers concluded: "It enhances the accuracy of FNA cytology and is of particular value for thyroid nodules with indeterminate cytology. (J Clin Endocrinol Metab 94: 2092-2098, 2009)." Nikiforov and colleagues published their study in the Journal of Clinical Endocrinology & Metabolism (Molecular Testing for Mutations in Improving the Fine-Needle Aspiration Diagnosis of Thyroid Nodules. Journal of Clinical Endocrinology & Metabolism, 2009;94(6):2092-2098). For additional information, contact Y.E. Nikiforov, University of Pittsburgh Med Canter, Dept. of Pathology, Presbyterian Hospital, 200 Lothrop St., C-606, Pittsburgh, PA 15213, USA. The publisher's contact information for the Journal of Clinical Endocrinology & Metabolism is: Endocrine Society, 8401 Connecticut Avenue, Suite 900, Chevy Chase, MD 20815-5817, USA. Keywords: United States, Pittsburgh, Cancer, Cancer Diagnosis, Carcinoma Diagnosis, Clinical Endocrinology, Cytology, Diagnostics, Medical Device, Metabolism, Oncology, Pathology, Thyroid Nodule, University of Pittsburgh. This article was prepared by Clinical Oncology Week editors from staff and other reports. Copyright 2009, Clinical Oncology Week via NewsRx.com.
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