Monitoring Outcomes of Indeterminate Thyroid Nodules and Predictive Capabilities of Molecular Testing.

IF 1.3 4区医学 Q3 OTORHINOLARYNGOLOGY

Annals of Otology Rhinology and Laryngology Pub Date : 2024-10-01 Epub Date: 2024-07-29 DOI:10.1177/00034894241264380

Samuel Garrett, David Millay, James Pierre, Natalia Pluta, Christopher Russo, Daniel Neelon, Elizabeth Bauer, Thanh Hoang, Michael Orestes

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引用次数: 0

Abstract

Objective: This study aimed to compare the effectiveness of reflex molecular testing at identifying thyroid malignancy in indeterminate thyroid nodules (ITNs) since its implementation at our institution.

Method: Identified all ITNs at our institution from January 2010 to October 2020. Calculated the sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of ThyroSeq since the initiation of universal reflex testing of all first-time ITNs beginning in March 2016. Analyze effect on frequency of diagnostic surgeries.

Results: Study group: March 2016 to October 2020, 378 ITNs underwent ThyroSeq (318 Bethesda III and 60 Bethesda IV). Mean age 52 years, 35.9% male, 61.1% female. 145 surgically excised with overall resection rate of 38.4% (III: 32.7%; IV 68%). Final histology: 49 malignant with overall rate of malignancy (ROM) of ITNs at 33.8% (III: 31.7%; IV: 39%). ThyroSeq sensitivity for ITNs at 84% (III 78.8%, IV 93.8%). ThyroSeq NPV for ITNs at 86% (III 84%, IV 93.3%). ThyroSeq specificity for ITNs at 52% (III 50.7%, IV 56%). ThyroSeq PPV for ITNs at 47% (III 42.6%, IV 57.7%). Control group: From January 2010 to February 2016 there were 242 ITNs (152 Bethesda III, 90 Bethesda IV). Mean age 52.6 years, 25.8% male, 74.2% female. 157 cases were surgically excised, with an overall resection rate of 64.9% (III: 57.2%; IV: 77.8%). Final histology: 32 malignant, with overall ROM of ITNs at 20.4% (III: 27.6%; IV: 11.4%).

Conclusion: The initiation of universal Thyroseq (sensitivity 84% and NPV 86%) of ITNs at our institution has significantly decreased our percentage of diagnostic lobectomies, with a decreased resection rate of 26.5%.

查看原文本刊更多论文

监测不确定甲状腺结节的结果和分子检测的预测能力。

目的本研究旨在比较反射分子检测在我院实施以来对不确定甲状腺结节（ITN）中甲状腺恶性肿瘤的识别效果：确定本院自2010年1月至2020年10月期间的所有ITN。计算 ThyroSeq 自 2016 年 3 月开始对所有首次 ITN 进行普遍反射检测以来的灵敏度、特异性、阴性预测值 (NPV) 和阳性预测值 (PPV)。分析对诊断性手术频率的影响：研究组：2016年3月至2020年10月，378名ITN接受了ThyroSeq（318名Bethesda III和60名Bethesda IV）。平均年龄 52 岁，男性占 35.9%，女性占 61.1%。手术切除 145 例，总切除率为 38.4%（III 期：32.7%；IV 期：68%）。最终组织学结果：49 例恶性，ITN 的总恶性率 (ROM) 为 33.8%（III 期：31.7%；IV 期：39%）。ITN的ThyroSeq灵敏度为84%（III为78.8%，IV为93.8%）。ThyroSeq 对 ITNs 的 NPV 为 86%（III 为 84%，IV 为 93.3%）。ThyroSeq 对 ITNs 的特异性为 52%（III 为 50.7%，IV 为 56%）。ITNs 的 ThyroSeq PPV 为 47%（III 为 42.6%，IV 为 57.7%）。对照组：从 2010 年 1 月至 2016 年 2 月，共有 242 个 ITN（152 个 Bethesda III，90 个 Bethesda IV）。平均年龄 52.6 岁，男性占 25.8%，女性占 74.2%。手术切除 157 例，总切除率为 64.9%（III 期：57.2%；IV 期：77.8%）。最终组织学结果：32例为恶性，ITN的总ROM为20.4%（III：27.6%；IV：11.4%）：我院开始对ITN进行Thyroseq检查（灵敏度84%，NPV 86%），大大降低了诊断性肺叶切除术的比例，切除率降低了26.5%。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Otology Rhinology and Laryngology 医学-耳鼻喉科学

CiteScore

3.10

自引率

7.10%

发文量

171

审稿时长

4-8 weeks

期刊介绍： The Annals of Otology, Rhinology & Laryngology publishes original manuscripts of clinical and research importance in otolaryngology–head and neck medicine and surgery, otology, neurotology, bronchoesophagology, laryngology, rhinology, head and neck oncology and surgery, plastic and reconstructive surgery, pediatric otolaryngology, audiology, and speech pathology. In-depth studies (supplements), papers of historical interest, and reviews of computer software and applications in otolaryngology are also published, as well as imaging, pathology, and clinicopathology studies, book reviews, and letters to the editor. AOR is the official journal of the American Broncho-Esophagological Association.