Update on Molecular Testing for Cytologically Indeterminate Thyroid Nodules
Update on Molecular Testing for Cytologically Indeterminate Thyroid Nodules
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DOI：
10.5858/arpa.2017-0174-ra
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发表时间：
2018-04-01
影响因子：
4.6
通讯作者：
Nikiforova, Marina
中科院分区：
文献类型：
--
作者：
Nishino, Michiya;Nikiforova, Marina
背景：大约 15% 至 30% 的接受细针抽吸的甲状腺结节被归类为细胞学不确定的，这给患者和临床医生带来了管理挑战。在过去的几年中，已经开发了几种分子测试来减少不确定的甲状腺细针抽吸标本的诊断不确定性。目的 - 回顾目前销售的用于细胞学不确定的甲状腺细针抽吸标本的 4 种分子测试的方法、临床验证和最近的同行评审文献：Afirma、ThyroSeq、ThyGenX/ThyraMIR 和 RosettaGX Reveal。来源。-从 PubMed 搜索中检索到的同行评审文献、公司网站和代表提供的数据以及作者的个人经历。结论。-4 种商业化的甲状腺细胞学分子测试提供了独特的方法来改善甲状腺结节的风险分层。熟悉验证研究的数据以及有关验证后环境中测试性能的新兴文献可以帮助用户以有临床意义的方式选择和解释这些测试。
Context.-Approximately 15% to 30% of thyroid nodules that undergo fine-needle aspiration are classified as cytologically indeterminate, presenting management challenges for patients and clinicians alike. During the past several years, several molecular tests have been developed to reduce the diagnostic uncertainty of indeterminate thyroid fine-needle aspirations.Objective.-To review the methodology, clinical validation, and recent peer-reviewed literature for 4 molecular tests that are currently marketed for cytologically indeterminate thyroid fine-needle aspiration specimens: Afirma, ThyroSeq, ThyGenX/ThyraMIR, and RosettaGX Reveal.Data Sources.-Peer-reviewed literature retrieved from PubMed search, data provided by company websites and representatives, and authors' personal experiences.Conclusions.-The 4 commercially available molecular tests for thyroid cytology offer unique approaches to improve the risk stratification of thyroid nodules. Familiarity with data from the validation studies as well as the emerging literature about test performance in the post-validation setting can help users to select and interpret these tests in a clinically meaningful way.