Felger, Erin A Lee, Wen Papoian, Vardan Rosen, Jennifer E Wartofsky, Leonard

Differentiated thyroid cancer and Hashimoto thyroiditis: Utility of the Afirma gene expression classifier. - 2020

BACKGROUND AND OBJECTIVES: The Afirma gene expression classifier (AGEC) has not been tested or validated in a high-risk group, such as patients with Hashimoto's thyroiditis (HT). We hypothesized that AGEC would perform worse in patients with HT. CONCLUSIONS: We observed a lower NPV for AGEC to rule out thyroid cancer in patients with HT, which reduces the utility of the test for this population. Copyright (c) 2020 Wiley Periodicals, Inc. METHODS: A retrospective review of patient charts in a single academic institution who underwent thyroidectomy between 2012 and 2017 was conducted. Patients with HT who underwent AGEC were identified to calculate sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). RESULTS: We identified 69 patients with HT and atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) on cytology who underwent AGEC analysis. The mean age of AGEC cohort was 50 years (range, 26-77 years) with 90% female. The median nodule size was 1.9 cm (interquartile range [IQR], 1.2-2.7 cm). Of the 69 patients, 62 showed suspicious AGEC of which 26 showed TC on surgical pathology. Of the seven benign AGEC, two showed TC on surgical pathology. The sensitivity, specificity, PPV, and NPV were 93%, 12%, 42%, and 71%, respectively. Of the entire AGEC cohort, 17 (43%) showed multicentric disease.



10.1002/jso.25875 [doi]

Thyroid Nodule/su [Surgery]
Thyroid Nodule/pa [Pathology]
Thyroid Nodule/ge [Genetics]
Thyroid Neoplasms/su [Surgery]
Thyroid Neoplasms/pa [Pathology]
*Thyroid Neoplasms/ge [Genetics]
Retrospective Studies
Reproducibility of Results
Middle Aged
Hashimoto Disease/su [Surgery]
Hashimoto Disease/pa [Pathology]
*Hashimoto Disease/ge [Genetics]
Gene Expression Profiling/mt [Methods]
Cohort Studies

MedStar Washington Hospital Center

Surgery/Endocrine Surgery
Surgery/General Surgery

Journal Article

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