J Cancer 2020; 11(24):7276-7282. doi:10.7150/jca.46086 This issue Cite

Research Paper

Risk Stratification Study of Indeterminate Thyroid Nodules with a next-generation Sequencing Assay with Residual ThinPrep® Material

Huan Zhao1*, Weiwei Jing1*, Weihua Li1, Zhihui Zhang1, Jian Cao1, Linlin Zhao1, Yue Sun1, Cong Wang1, Yong Wang2✉, Huiqin Guo1✉

1. Department of Pathology, National Cancer Center/ National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
2. Department of Ultrasound, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College.
*These authors contributed equally to this work.

Citation:
Zhao H, Jing W, Li W, Zhang Z, Cao J, Zhao L, Sun Y, Wang C, Wang Y, Guo H. Risk Stratification Study of Indeterminate Thyroid Nodules with a next-generation Sequencing Assay with Residual ThinPrep® Material. J Cancer 2020; 11(24):7276-7282. doi:10.7150/jca.46086. https://www.jcancer.org/v11p7276.htm
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Abstract

Objective: The management of indeterminate thyroid nodules is challenging. Molecular testing has emerged as a promising method for stratifying this gray area of fine-needle aspiration (FNA) cytology. Next-generation sequencing (NGS) can be used to test a large variety of genetic changes with very small amounts of nucleic acids obtained from FNA samples.

Methods: Thyroid FNA assays were classified according to the Bethesda System for Reporting Thyroid Cytopathology after routine ThinPrep® slide preparation. Indeterminate nodules with surgical outcomes were assayed with an 18-gene NGS panel with the residual ThinPrep® material, including nodules categorized as atypia of undetermined significance (AUS)/follicular lesions of undetermined significance (FLUS) or follicular neoplasm (FN)/suspicious for a follicular neoplasm (SFN). We evaluated the diagnostic efficacy of the 18-gene panel for thyroid malignancies and potential malignancies and compared it with a well-accepted examination, ThyroSeq v2 testing.

Results: A total of 36 indeterminate nodules were assayed, seven were categorized as AUS/FLUS and 29 as FN/SFN. All of them had adequate DNA for the NGS procedure. When noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was considered malignant, the risk of malignancy was 71.4% for AUS/FLUS nodules, and 69.0%for FN/SFN nodules. The 18-gene panel showed 72.0% sensitivity, 72.7% specificity, 85.7% positive predictive value (PPV), and 53.3% negative predictive value (NPV) in identifying malignancies and potential malignancies in the indeterminate nodules. Compared with a multicenter report from ThyroSeq v2 testing, 18-gene panel showed a lower NPV (p=0.005), but a higher PPV (p=0.02).

Conclusions: NGS assays are feasible on residual ThinPrep® material, with the advantage of not requiring additional FNA procedure. The 18-gene panel testing can be used as a 'rule in' test for surgical management based on indeterminate nodules and showed a lower NPV but a higher PPV compared to ThyroSeq v2 testing.

Keywords: fine-needle aspiration, cytology, thyroid nodules, thyroid cancer, molecular diagnosis


Citation styles

APA
Zhao, H., Jing, W., Li, W., Zhang, Z., Cao, J., Zhao, L., Sun, Y., Wang, C., Wang, Y., Guo, H. (2020). Risk Stratification Study of Indeterminate Thyroid Nodules with a next-generation Sequencing Assay with Residual ThinPrep® Material. Journal of Cancer, 11(24), 7276-7282. https://doi.org/10.7150/jca.46086.

ACS
Zhao, H.; Jing, W.; Li, W.; Zhang, Z.; Cao, J.; Zhao, L.; Sun, Y.; Wang, C.; Wang, Y.; Guo, H. Risk Stratification Study of Indeterminate Thyroid Nodules with a next-generation Sequencing Assay with Residual ThinPrep® Material. J. Cancer 2020, 11 (24), 7276-7282. DOI: 10.7150/jca.46086.

NLM
Zhao H, Jing W, Li W, Zhang Z, Cao J, Zhao L, Sun Y, Wang C, Wang Y, Guo H. Risk Stratification Study of Indeterminate Thyroid Nodules with a next-generation Sequencing Assay with Residual ThinPrep® Material. J Cancer 2020; 11(24):7276-7282. doi:10.7150/jca.46086. https://www.jcancer.org/v11p7276.htm

CSE
Zhao H, Jing W, Li W, Zhang Z, Cao J, Zhao L, Sun Y, Wang C, Wang Y, Guo H. 2020. Risk Stratification Study of Indeterminate Thyroid Nodules with a next-generation Sequencing Assay with Residual ThinPrep® Material. J Cancer. 11(24):7276-7282.

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