ArticleBMC medicine2015
The variable phenotype and low-risk nature of RAS-positive thyroid nodules.
Article in BMC medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
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Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it, 89 citations in OpenAlex.
- Molecular Variants and Their Risks for Malignancy in Cytologically Indeterminate Thyroid Nodules.Thyroid : official journal of the American Thyroid Association · 2019Pooled it
- The Molecular Heterogeneity of NRAS Variants in Thyroid Nodules.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026Article
- Single-cell transcriptomic analysis reveals tumor-immune determinants of lymph node colonization and progression in thyroid cancer.Science advances · 2026Article
- Article
- Ultrasound-guided microwave ablation for small thyroid nodules with RAS mutation: a pilot study.Frontiers in oncology · 2026Article
- Multi-omics clustering analysis carries out the molecular-specific subtypes of thyroid carcinoma: implicating for the precise treatment strategies.Genes and immunity · 2025Article
- Molecular Markers in Follicular and Oncocytic Thyroid Carcinomas: Clinical Application of Molecular Genetic Testing.Current oncology (Toronto, Ont.) · 2024Article
- RAS-Mutant Follicular Thyroid Tumors: A Continuous Challenge for Pathologists.Endocrine pathology · 2024Review
- Discriminating Interpatient Variabilities of RAS Gene Variants for Precision Detection of Thyroid Cancer.JAMA network open · 2024Article
- Article
- Real-life utility of five-gene panel test in preoperative thyroid fine-needle aspiration biopsy: a large cohort of 740 patients study.Endocrine · 2023Article
- Effect of Having Concurrent Mutations on the Degree of Aggressiveness in Patients with Thyroid Cancer Positive forCancers · 2023Article
- The Significance of RAS-Like Mutations and MicroRNA Profiling in Predicting Malignancy in Thyroid Biopsy Specimens.Endocrine pathology · 2022Article
- Significance of RAS Mutations in Thyroid Benign Nodules and Non-Medullary Thyroid Cancer.Cancers · 2021Review
- Genetic Determinants for Prediction of Outcome of Patients with Papillary Thyroid Carcinoma.Cancers · 2021Article
- Molecular Determinants of Thyroid Nodules with Indeterminate Cytology andThyroid : official journal of the American Thyroid Association · 2021Article
- Correlation of ThyroSeq Results with Surgical Histopathology in Cytologically Indeterminate Thyroid Nodules.Endocrine pathology · 2020Article
- Contemporary Thyroid Nodule Evaluation and Management.The Journal of clinical endocrinology and metabolism · 2020Review
- Article
- Genetic-guided Risk Assessment and Management of Thyroid Cancer.Endocrinology and metabolism clinics of North America · 2019Review
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15 authors at 1 institution in 1 country.
Funding
Abstract
backgroundOncogenic mutations are common in thyroid cancers. While the frequently detected RAS-oncogene mutations have been studied for diagnostic use in cytologically indeterminate thyroid nodules, no investigation has studied such mutations in an unselected population of thyroid nodules. No long-term study of RAS-positive thyroid nodules has been performed.
methodsWe performed a prospective, blinded cohort study in 362 consecutive patients presenting with clinically relevant (>1 cm) thyroid nodules. Fine needle aspiration cytology and mutational testing were obtained for all nodules. Post-operative histopathology was obtained for malignant or indeterminate nodules, and benign nodules were sonographically followed. Histopathological features were compared between RAS- and BRAF-positive malignancies. RAS-positive benign nodules were analyzed for growth or cellular change from prior aspirations.
resultsOverall, 17 of 362 nodules were RAS-positive. Nine separate nodules were BRAF-positive, of which eight underwent surgery and all proved malignant (100%). Out of the 17 RAS-positive nodules, ten underwent surgery, of which eight proved malignant (47%). All RAS-positive malignancies were low risk - all follicular variants of papillary carcinoma, without extrathyroidal extension, metastases, or lymphovascular invasion. RAS-positivity was associated with malignancy in younger patients (P = 0.028). Of the nine RAS-positive benign nodules, five had long-term prospective sonographic follow-up (mean 8.3 years) showing no growth or signs of malignancy. Four of these nodules also had previous aspirations (mean 5.8 years prior), all with similar benign results.
conclusionsWhile RAS-oncogene mutations increase malignancy risk, these data demonstrate a low-risk phenotype for most RAS-positive cancers. Furthermore, cytologically benign, yet RAS-positive nodules behave in an indolent fashion over years. RAS-positivity alone should therefore not dictate clinical decisions.
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