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Positive Correlation of Thyroid Nodule Cytology with Molecular Profiling—a Single-Center Experience

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Abstract

Despite several reports on the association between molecular profiling, aggressive histology, and clinical outcomes, the association between mutation expression and pre-operative cytology is yet to be demonstrated. Therefore, we performed a retrospective, single-center study, including all patients who underwent molecular profiling of thyroid nodules in Bethesda System for Reporting Thyroid Cytopathology (BSRTC) categories III to VI, between 2018 and 2019. Medical records were reviewed to collect demographics, cytology results according to BSRTC, final pathology (presence of malignancy and its type, as well as presence of aggressive features, including extrathyroidal extension, positive neck lymph nodes, and multifocality), and the identified genetic variants stratified by risk levels, according to the 2015 ATA guidelines. We supplemented this analysis with a systematic review to identify the variant distributions across the literature. We included data on 55 nodules from 48 patients for the final analysis. A significant positive correlation was found between BSRTC categories and the mutation risk level, shown by an increase in the intermediate to high-risk mutation rate in the higher BSRTC categories (Rs = 0.660, p ≤ 0.001). A significant positive correlation was also found between mutation risk levels and the presence of malignancy and aggressive tumor features (Rs = 0.637, p < 0.001 and Rs = 0.459, p = 0.006, respectively). This novel positive and significant correlation between BSRTC categories and the mutation risk level provides additional insight to aid clinicians in the interpretation of BSRTC results and may contribute to the discussion of appropriate management of thyroid nodule with patients.

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Availability of Data and Materials

The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.

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Author notes

  1. Idit Tessler and Isaac Shochat contributed equally to this work.

Authors and Affiliations

  1. Faculty of Medicine, Hebrew University, Jerusalem, Israel

    Idit Tessler & Oded Cohen

  2. Department of Otolaryngology Head and Neck Surgery, Technion Faculty of Medicine, Hillel Yaffe Medical Center, 38100, Haifa, Israel

    Isaac Shochat & Galit Avior

  3. Faculty of Medicine, Technion, Haifa, Israel

    Isaac Shochat, Alona Meir & Galit Avior

  4. Department of Pathology, Hillel Yaffe Medical Center, Hadera, Israel

    Alona Meir

Authors
  1. Idit Tessler
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  2. Isaac Shochat
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  3. Oded Cohen
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  4. Alona Meir
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  5. Galit Avior
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Contributions

I.T, I.S, O.C, A.M, and G.A had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: I.T., I.S., and G.A. Acquisition of data: I.S., A.M., and G.A. Analysis and interpretation of data: I.T., I.S., O.C. Drafting of the manuscript: I.T. and I.S. Critical revision of the manuscript for important intellectual content: O.C. and G.A. Statistical analysis: I.T. and I.S. Study supervision: G.A.

Corresponding author

Correspondence to Galit Avior.

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Ethics Approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Hillel Yaffe Medical Center (approval number 3819).

Statement of Ethics

This clinical trial was conducted in compliance with good clinical practices (GCP) as specified in the Israeli Ministry of Health regulations as well as in the ICH GCP Guidelines.

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The authors declare no competing interests.

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Tessler, I., Shochat, I., Cohen, O. et al. Positive Correlation of Thyroid Nodule Cytology with Molecular Profiling—a Single-Center Experience. Endocr Pathol 32, 480–488 (2021). https://doi.org/10.1007/s12022-021-09680-3

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  • DOI: https://doi.org/10.1007/s12022-021-09680-3

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