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Gene expression classifier accurate for benign nodule detection

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DENVER — Most thyroid nodules identified as benign with a gene expression classifier, or GEC, remain benign and do not undergo surgical removal, according to findings presented at the Annual Meeting of the American Thyroid Association.

“The majority of patients — more than 80% — with a ‘benign’ result on GEC remain unoperated during long-term follow-up,” Jennifer A. Sipos, MD, associate professor of medicine, director of the benign thyroid disorders program at The Ohio State University School of Medicine in Columbus, told Endocrine Today. “Of those patients who ultimately have surgery in spite of the benign GEC result, large nodule size is the principal reason for removal.”

Jennifer A. Sipos

Sipos and colleagues evaluated 411 benign GEC results from six published studies with a medical follow-up of 7 months or longer. The longest follow-up time was 44 months.

Among studies with follow-up greater than 1 year, 85% of the patients with benign results avoided surgery.

In a study that included histopathology results, there was one reported cancer among GEC-benign nodules (1.1%). There was no statistical difference between proportion of nodules demonstrating growth or cancer detection in GEC-benign nodules compared with cytopathologically benign nodules. Further, there was no statistical difference between cytopathologically benign nodules and GEC-benign nodules for the rate of follow-up ultrasound evaluation or thyroid surgery.

“A benign result on the GEC has a durable effect of keeping patients out of the operating room for their indeterminate nodules,” Sipos told Endocrine Today. “The GEC is an additional tool available to clinicians to direct the management of indeterminate thyroid nodules. We always need more studies demonstrating this same effect with larger numbers of patients. Additionally, studies focusing on the sonographic change in appearance — size and sonographic features of malignancy — of the GEC-benign nodules over time would be beneficial.” – by Amber Cox

Reference:

Sipos JA, et al. Poster 139. Presented at: 86th Annual Meeting of the American Thyroid Association; Sept. 21-25, 2016; Denver.

Disclosure: Sipos reports no relevant financial disclosures.