Evidence map›Paper›PMID 28152275›Full record

ArticleCancer cytopathology2017

Qualifiers of atypia in the cytologic diagnosis of thyroid nodules are associated with different Afirma gene expression classifier results and clinical outcomes.

Sylvan C Baca, Kristine S Wong, Kyle C Strickland, Howard T Heller, Matthew I Kim, Justine A Barletta, Edmund S Cibas, Jeffrey F Krane, Ellen Marqusee, Trevor E Angell

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer cytopathology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 4 pooled it
7.1field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 4 syntheses or guidelines pooled it, 75 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Sylvan C BacaDepartment of Medicine, The Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Kristine S WongDepartment of Pathology, The Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Kyle C StricklandDepartment of Pathology, The Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Howard T HellerDepartment of Radiology, The Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Matthew I KimThyroid Section, Division of Endocrinology, Hypertension, and Diabetes, The Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Justine A BarlettaDepartment of Pathology, The Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Edmund S CibasDepartment of Pathology, The Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.ORCID 0000-0003-1987-2004
Jeffrey F KraneDepartment of Pathology, The Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.ORCID 0000-0001-7768-3901
Ellen MarquseeThyroid Section, Division of Endocrinology, Hypertension, and Diabetes, The Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Trevor E AngellThyroid Section, Division of Endocrinology, Hypertension, and Diabetes, The Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Brigham and Women's Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThyroid nodules with atypia of undetermined significance (AUS) on fine-needle aspiration (FNA) have a low risk of malignancy that appears to vary based on specific features described in the AUS diagnosis. The Afirma gene expression classifier (GEC) is a molecular test designed to improve preoperative risk stratification of thyroid nodules, but its performance for different patterns of AUS has not been defined. The objective of this study was to assess GEC results and clinical outcomes in AUS nodules with architectural atypia (AUS-A), cytologic atypia (AUS-C) or both (AUS-C/A).

methodsThis was a retrospective review of all thyroid nodules with AUS cytopathology that underwent GEC testing at the authors' institution over a period of >4 years.

resultsIn 227 nodules that had AUS cytology results and Afirma GEC testing, the rate of benign GEC results was higher in AUS-A nodules (70 of 107; 65%) than in AUS-C/A nodules (25 of 65; 38%; P = .0008), and AUS-C nodules exhibited an intermediate rate of benign results (27 of 55 nodules; 59%). The risk of cancer among patients who had GEC-suspicious nodules, 86% of whom underwent resection, was 19% (6 of 25) for AUS-A nodules compared with 57% (21 of 37) for AUS-C/A nodules (P = .003) and 45% (10 of 22) for AUS-C nodules (P = .07). In nodules that had an indeterminate repeat cytology result, no difference was observed in the rate of benign GEC results or in the malignancy rate compared with nodules that had a single cytology result.

conclusionsThe performance characteristics of Afirma GEC testing vary, depending on qualifiers of cytologic atypia. Recognition of these differences may enable clinicians to provide improved counseling and treatment recommendations to patients. Cancer Cytopathol 2017;125:313-322. © 2017 American Cancer Society.

Indexed as

TranscriptomeAdenocarcinoma, FollicularAdenomaAdultAgedBiopsy, Fine-NeedleCarcinomaCarcinoma, PapillaryCytodiagnosisFemaleGene Expression ProfilingHumansMaleMiddle AgedRetrospective StudiesRisk AssessmentAfirma gene expression classifierarchitectural atypiaatypia of undetermined significance (AUS)cytologic atypiacytologyfollicular lesion of undetermined significance (FLUS)indeterminate cytologythyroid nodule

Identifiers

PMID28152275
PMCPMC5484344
OpenAlexW2585091360

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.