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Eur Thyroid J. 2017 Jul;6(3):115-129. doi: 10.1159/000468519. Epub 2017 May 19.

European Thyroid Association Guidelines regarding Thyroid Nodule Molecular Fine-Needle Aspiration Cytology Diagnostics.

Author information

1
Division of Endocrinology and Metabolism, Departments of Medicine, Pathology, Oncology and Arnie Charbonneau Cancer Institute, Calgary, AB, Canada.
2
Department of Medical, Surgical, and Neurological Sciences, Endocrinology Section, University of Siena, Siena, Italy.
3
Pathology Unit, University Hospital Campus Bio-Medico, Rome, Italy.
4
Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland.
5
Endocrine Surgery Section, Department of General, Visceral, and Transplantation Surgery, University Medicine of the Johannes Gutenberg-University Mainz, Mainz, Germany.
6
Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal.

Abstract

Molecular fine-needle aspiration (FNA) cytology diagnostics has the potential to address the inherent limitation of FNA cytology which is an indeterminate (atypia of undetermined significance/follicular lesion of undetermined significance follicular neoplasm) cytology. Because of the emerging role of molecular FNA cytology diagnostics, the European Thyroid Association convened a panel of international experts to review methodological aspects, indications, results, and limitations of molecular FNA cytology diagnostics. The panel reviewed the evidence for the diagnostic value of mutation panel assessment (including at least BRAF, NRAS, HRAS, KRAS, PAX8/PPARG, RET/PTC) of targeted next generation sequencing and of a microarray gene expression classifier (GEC) test in the diagnostic assessment of an indeterminate cytology thyroid nodule. Moreover, possible surgical consequences of molecular FNA diagnostic results of thyroid nodules and the evidence that analysis of a molecular FNA diagnostic panel of somatic mutations or a microarray GEC test can alter the follow-up were reviewed. Molecular tests may help clinicians to drive patient care and the surgical decision if the analysis is performed in specialized laboratories. These molecular tests require standardization of performance characteristics and appropriate calibration as well as analytic validation before clinical interpretation.

KEYWORDS:

European Thyroid Association; Fine-needle aspiration; Thyroid

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