000			03682nam a22006977a 4500
008			200709s20202020 xxu||||| |||| 00| 0 eng d
022			_a0022-4790
024			_a10.1002/jso.25875 [doi]
040			_aOvid MEDLINE(R)
099			_a32115718
245			_aDifferentiated thyroid cancer and Hashimoto thyroiditis: Utility of the Afirma gene expression classifier.
251			_aJournal of Surgical Oncology. 121(7):1053-1057, 2020 Jun.
252			_aJ Surg Oncol. 121(7):1053-1057, 2020 Jun.
252			_zJ Surg Oncol. 121(7):1053-1057, 2020 Jun.
253			_aJournal of surgical oncology
260			_c2020
260			_fFY2020
265			_sppublish
266			_d2020-07-09
268			_aJournal of Surgical Oncology. 121(7):1053-1057, 2020 Jun.
520			_aBACKGROUND 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.
520			_aCONCLUSIONS: 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.
520			_aMETHODS: 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).
520			_aRESULTS: 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.
546			_aEnglish
650			_a*Hashimoto Disease/ge [Genetics]
650			_a*Thyroid Neoplasms/ge [Genetics]
650			_aAdult
650			_aAged
650			_aCohort Studies
650			_aFemale
650			_aGene Expression Profiling/mt [Methods]
650			_aHashimoto Disease/pa [Pathology]
650			_aHashimoto Disease/su [Surgery]
650			_aHumans
650			_aMale
650			_aMiddle Aged
650			_aReproducibility of Results
650			_aRetrospective Studies
650			_aThyroid Neoplasms/pa [Pathology]
650			_aThyroid Neoplasms/su [Surgery]
650			_aThyroid Nodule/ge [Genetics]
650			_aThyroid Nodule/pa [Pathology]
650			_aThyroid Nodule/su [Surgery]
650			_aThyroidectomy
651			_aMedStar Washington Hospital Center
656			_aMedicine/Endocrinology
656			_aPathology
656			_aSurgery/Endocrine Surgery
656			_aSurgery/General Surgery
657			_aJournal Article
700			_aFelger, Erin A
700			_aLee, Wen
700			_aPapoian, Vardan
700			_aRosen, Jennifer E
700			_aWartofsky, Leonard
790			_aFelger EA, Lee W, Papoian V, Rosen JE, Wartofsky L
856			_uhttps://dx.doi.org/10.1002/jso.25875 _zhttps://dx.doi.org/10.1002/jso.25875
858			_yPapoian, Vardan _uhttp://orcid.org/0000-0002-2572-1483 _zhttp://orcid.org/0000-0002-2572-1483
942			_cART _dArticle
999			_c11197 _d11197