Molecular Profiling for Bethesda III to VI Nodules: Results of a Multicenter International Retrospective Study
Authors' conclusion
Molecular testing of thyroid nodules can help determine the likelihood of malignancy and classify nodules into several tumor phenotypes, predicting their behaviors and potentially allowing for a more tailored treatment. NBNR alterations should be managed with caution.
Study context
- Population
- Patients with thyroid nodules with Bethesda III to VI cytology who had preoperative molecular profiling (ThyGenX/ThyGeNEXT or ThyroSeq V3) and surgery, 2015–2022603 (76.2%) females
- Participants
- 784 patients
- Exposure
- Molecular phenotypes: BRAF-like vs RAS-like vs non-BRAF-non-RAS
- Outcome
- Association of molecular phenotypes with Bethesda category, ETE, nodal disease and aggressive PTC subtypes
Main finding
As reported in the abstract
- BRAF-like alterations most likely in Bethesda V and VI nodules and with extrathyroidal extension (ETE), nodal disease and/or aggressive papillary thyroid cancer (PTC) subtypes
- P < .001 for all
- RAS-like alterations more common in Bethesda III and IV nodules, less likely to show ETE, nodal disease and/or aggressive histology
- P < .001 for all
- Non-BRAF-non-RAS (NBNR) alterations rarely but significantly associated with poorly differentiated thyroid cancer
- P < .005
Observational data: associations, not effects.
Further findings
Histology
- PTC
- 727 (91.9%)
- Aggressive PTC subtype (eg, tall cell and hobnail)
- 205 (28.2%)
Original publication
Molecular Profiling for Bethesda III to VI Nodules: Results of a Multicenter International Retrospective Study. Endocr Pract. Published 5 January 2024. doi:10.
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