Management of Thyroid Nodular Disease: Current Cytopathology Classifications and Genetic Testing

Lindsay E Kuo; Rachel R Kelz

doi:10.1016/j.soc.2015.08.001

Management of Thyroid Nodular Disease: Current Cytopathology Classifications and Genetic Testing

Surg Oncol Clin N Am. 2016 Jan;25(1):1-16. doi: 10.1016/j.soc.2015.08.001. Epub 2015 Oct 31.

Authors

Lindsay E Kuo¹, Rachel R Kelz²

Affiliations

¹ Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein, Philadelphia, PA 19104, USA.
² Division of Endocrine and Oncologic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 4 Silverstein, Philadelphia, PA 19104, USA. Electronic address: Rachel.Kelz@uphs.upenn.edu.

PMID: 26610771
DOI: 10.1016/j.soc.2015.08.001

Abstract

Preoperative diagnosis and operative planning for patients with thyroid nodules has improved over the last decade. The Bethesda criteria for cytopathologic classification of thyroid nodule aspirate has enhanced communication between pathologists and clinicians. Multiple genetic tests, including molecular markers and the Afirma gene expression classifier, have been developed and validated. The tests, along with clinical and radiologic information, are most useful in the setting of indeterminate cytology. The development of an updated diagnostic and treatment algorithm incorporating all available tests will help standardize the management of patients with nodular thyroid disease and reduce variation and inefficiencies in care.

Keywords: Afirma; Bethesda classification; Genetic testing; Molecular markers; Thyroid nodules.

Publication types

Review

MeSH terms

Cytodiagnosis / methods
Gene Expression Profiling / methods
Genetic Testing
Humans
Thyroid Nodule / classification*
Thyroid Nodule / diagnosis*
Thyroid Nodule / genetics*