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Low thyroidectomy rate linked to benign gene expression classifier result
Use of a gene expression classifier to identify thyroid nodules as benign may help reduce the rate of thyroid surgery, according to study findings published in Endocrine Practice.
“The arrival of the era of molecular testing brings with it questions and opportunities regarding the long-term management and follow-up of patients with molecularly tested thyroid nodules,” the researchers wrote. “The objective of molecular testing with the [gene expression classifier] test is to identify benign nodules among those with indeterminate cytology, thereby circumventing a diagnostic thyroidectomy.”
Jennifer A. Sipos, MD, from Ohio State University, and colleagues evaluated 98 patients with a thyroid nodule that was evaluated by fine-needle aspiration 3 or more years before the date of data collection followed with use of the Afirma gene expression classifier (GEC; Veracyte Inc.) to determine the rate of surgical intervention in patients with benign GEC results. Researchers also sought to determine the physician’s opinion on the safety of GEC use.
Median follow-up was 26 months, and 17 patients underwent a thyroidectomy.
Ten thyroidectomies were performed within the first year after a benign GEC result, and 88% of all thyroidectomies were performed within 2 years after receiving a benign GEC result. Rapid nodule growth and large nodule growth were the most common indications for surgery.
Eighty-six percent of physicians reported that the GEC improved patient safety compared with not using it, whereas 12% reported it had no effect.
“This study demonstrates that a ‘benign’ GEC result is associated with a low operative rate,” the researchers wrote. “The majority of surgeries occur in the first 12 months after a ‘benign’ GEC test; very few surgeries were performed beyond 2 years of follow-up. The majority of clinicians using the GEC felt that it improved patient safety compared to not using it. Therefore, it appears that GEC testing is associated with a durable reduction in the rate of surgery that clinicians believe is safe when patients are followed for 36 months after a ‘benign’ GEC result.” – by Amber Cox
Disclosure: Endocrine Today was unable to confirm any relevant financial disclosures.