Cytologic and Molecular Assessment of Isthmus Thyroid Nodules and Carcinomas
Authors' conclusion
These data suggest isthmic nodules are more likely to have malignant cytology and increased rates of higher risk molecular alterations compared with lobar nodules. IF-PTC from the isthmus is molecularly different compared with IF-PTC from the lobes.
Study context
- Population
- Afirma thyroid nodule database; histopathology reports of papillary thyroid cancer (PTC) and infiltrative follicular subtype of PTC (IF-PTC) from Afirma discovery cohorts and a community endocrine surgery practiceAfirma database
- Participants
- 177,227 participants
- Exposure
- Isthmus vs lobar thyroid nodules
- Isthmusn = 8,527
- Outcome
- Bethesda V-VI nodules
Methodological detailsgenome-wide differential expression analysis
- Genome-wide differential expression analysis
Main finding
As reported in the abstract
P < 0.0001
Observational data: associations, not effects.
Further findings
BRAFp.V600E
P < 0.0001
ALK/NTRK/RET fusions
P < 0.0001
SPOP variants
P < 0.0001
NRAS mutations
P < 0.0001
PAX8::PPARy fusions
P < 0.0001
- IF-PTC: isthmus (n = 13) vs lobes (n = 181) · more BRAF-like, increased ERK and FMT scores with isthmus
- P < 0.01 for all
Transcriptome signatures
- Isthmus nodules had higher BRAF-like scores, ERK activity and FMT scores, and lower inflammation activity scores
- Genes downregulated in isthmus tumors enriched in immune response regulation
Original publication
Cytologic and Molecular Assessment of Isthmus Thyroid Nodules and Carcinomas. Thyroid. Published 11 November 2024. doi:10.
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