Afirma基因测序分类器在甲状腺细针穿刺结果不确定结节中的超声特征及性能

Ultrasound Features and Performance of Afirma Gene Sequencing Classifier in Cytologically Indeterminate Thyroid Nodules.

作者信息

Azaryan Irina, Endo Mayumi, Sipos Jennifer A, Ma Jianing, Peng Jing, Nabhan Fadi

机构信息

Division of Endocrinology, Diabetes and Metabolism, The Ohio State University and Arthur G. James Cancer Center, Columbus, OH 43210, USA.

Division of Metabolism, Endocrinology, and Nutrition, University of Washington, Seattle, WA 98105, USA.

出版信息

J Endocr Soc. 2024 Jan 31;8(3):bvae010. doi: 10.1210/jendso/bvae010. eCollection 2024 Jan 16.

DOI:10.1210/jendso/bvae010

PMID:38348302

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10859306/

Abstract

BACKGROUND

Cytologically indeterminate thyroid nodules (ITN) pose a management challenge. Here we analyze if adding ultrasound characteristics to Afirma Genome Sequence Classifier (GSC) results increases GSC diagnostic performance.

METHODS

We retrospectively analyzed 237 GSC-tested Bethesda III/IV ITNs between July 2017 and December 2019 and classified them by American Thyroid Association (ATA) and the Thyroid Imaging Reporting and Data System (TIRADS) of the American College of Radiology.

RESULTS

The benign call rate was higher in Bethesda III ITNs with TIRADS <5 vs TIRADS 5 (89% vs 68%. = .015). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of GSC in ATA high-risk Bethesda III ITNs vs lower were 100% vs 80% ( = 1), 89.5% vs 91.5% ( = .67), 66.7% vs 25% ( = .13), and 100% vs 99.2% ( = 1), respectively, and for TIRADS 5 vs <5 were 100% vs 80% ( = 1), 88.2% vs 91.4% ( = .65), 71.4% vs 23.5% ( = .06), and 100% vs 99.3% ( = 1). The sensitivity, specificity, PPV, and NPV of GSC in high-risk ATA Bethesda IV ITNs vs lower were 66.7% vs 100% ( = .42), 83.3% vs 85.7% ( = 1), 66.7% vs 64.3% ( = 1), and 83.3% vs 100% ( = .3), respectively, and for TIRADS 5 vs <5 were 66.7% vs 90% ( = .42), 88.9% vs 83.8% ( = 1), 66.7% vs 60% ( = 1), and 88.9% vs 96.9% ( = .39).

CONCLUSION

Sensitivity, specificity, NPV, and PPV of GSC were not significantly different in ATA high-risk and TIRADS 5 ITNs compared to ATA < high-risk and TIRADS 1-4 ITNs.

摘要

背景

细胞学检查结果不确定的甲状腺结节（ITN）给治疗带来了挑战。在此，我们分析将超声特征添加到Afirma基因序列分类器（GSC）结果中是否会提高GSC的诊断性能。

方法

我们回顾性分析了2017年7月至2019年12月期间接受GSC检测的237个贝塞斯达III/IV级ITN，并根据美国甲状腺协会（ATA）和美国放射学会的甲状腺影像报告和数据系统（TIRADS）对其进行分类。

结果

TIRADS<5的贝塞斯达III级ITN的良性诊断率高于TIRADS 5的ITN（89%对68%，P = 0.015）。ATA高危贝塞斯达III级ITN与低危ITN相比，GSC的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）分别为100%对80%（P = 1）、89.5%对91.5%（P = 0.67）、66.7%对25%（P = 0.13）和100%对99.2%（P = 1）；TIRADS 5与<5的ITN相比，分别为100%对80%（P = 1）、88.2%对91.4%（P = 0.65）、71.4%对23.5%（P = 0.06）和100%对99.3%（P = 1）。ATA高危贝塞斯达IV级ITN与低危ITN相比，GSC的敏感性、特异性、PPV和NPV分别为66.7%对100%（P = 0.42）、83.3%对85.7%（P = 1）、66.7%对64.3%（P = 1）和83.3%对100%（P = 0.3）；TIRADS 5与<5的ITN相比，分别为66.7%对90%（P = 0.42）、88.9%对83.8%（P = 1）、66.7%对60%（P = 1）和88.9%对96.9%（P = 0.39）。