SINGLE INSTITUTION EXPERIENCE WITH AFIRMA AND THYROSEQ TESTING IN INDETERMINATE THYROID NODULES

Author Department

Internal Medicine; Medicine

Document Type

Article, Peer-reviewed

Publication Date

3-2021

Abstract

Background: Thyroid nodules are a very common, often incidental finding on physical exam or imaging. Of those that undergo fine needle aspiration, cytology is indeterminate in up to 15%. Molecular testing is increasingly being used to help identify which nodules may be high risk for malignancy and guide management in regard to clinical follow up or surgical intervention. Recently there has been an increase in publication of independent studies assessing the performance of these molecular tests and comparing "real world" data to the validation studies.

Methods: This retrospective study identified all thyroid nodules at our institution that had Afirma GEC, GSC or Thyroseq v3 molecular testing from January 2014-January 2020 and compared measurements of test performance between them at our institution, and then to the original validation studies and other published institutional data.

Results: Overall, the benign call rate was highest in the Afirma GSC group (78%) compared to the GEC group (60%) and Thyroseq group (66%). Surgical histopathology revealed malignancy in 6/31of biopsied nodules in the GEC group, 8/13 in the GSC group and 3/16 in the Thyroseq group. Based on our data, the GSC specificity (91.9%) and positive predictive value (61.5%) were higher than the GEC specificity (68.4%) and PPV (19.4%) as well as Thyroseq specificity (75%) and PPV (18.8%).

PMID

33764195

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