Usefulness of NRAS codon 61 mutation analysis and core needle biopsy for the diagnosis of thyroid nodules previously diagnosed as atypia of undetermined significance

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• 作者：Eun Kyung Jang ; Won Gu Kim ; Eui Young Kim ; Hyemi Kwon ; Yun Mi Choi…
• 关键词：Thyroid nodule ; Thyroid neoplasm ; Thyroid cancer ; Biopsy ; NRAS oncogene
• 刊名：Endocrine
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：52
• 期：2
• 页码：305-312
• 全文大小：405 KB
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• 作者单位：Eun Kyung Jang (1)
  Won Gu Kim (2)
  Eui Young Kim (1)
  Hyemi Kwon (2)
  Yun Mi Choi (2)
  Min Ji Jeon (2)
  Jung Hwan Baek (3)
  Jeong Hyun Lee (3)
  Tae Yong Kim (2)
  Young Kee Shong (2)
  Jene Choi (4)
  Dong Eun Song (4)
  Won Bae Kim (2)
  
  1. Department of Endocrinology, Dongnam Institute of Radiological and Medical Sciences Cancer Center, Busan, Korea
  2. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro, 43-gil Songpa-gu, Seoul, 138-736, Korea
  3. Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Korea
  4. Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, Korea
  
• 刊物主题：Endocrinology; Diabetes; Internal Medicine; Science, general;
• 出版者：Springer US
• ISSN：1559-0100

文摘

A repeat fine needle aspiration (FNA) is recommended for thyroid nodules diagnosed as atypia of undetermined significance (AUS) in a previous cytology. We evaluated the utility of NRAS codon 61 (NRAS61) mutation analysis and core needle biopsy (CNB) for the diagnosis of thyroid nodules previously diagnosed as AUS. This study enrolled 236 patients who underwent both NRAS61 mutation analysis and CNB of thyroid nodules previously diagnosed as AUS at cytology. The NRAS61 mutation was detected in 36 nodules and was more frequently detected in the AUS and follicular neoplasm (FN)/suspicious for follicular neoplasm (SFN) categories, as determined by histological analysis of CNB, than in the benign group (p = 0.005). Sixty-one patients underwent surgery, and 29 nodules were finally diagnosed as malignant after surgery. Among 61 patients who underwent surgery, nodules with the NRAS61 mutation (42–65 %) had a significantly higher malignancy rate than nodules with wild-type NRAS61 (7–37 %, p = 0.038). The association between malignancy and the NRAS61 mutation was significant after adjusting for age, sex, nodule size, and histological diagnosis of CNB (p = 0.01). NRAS61 mutation analysis together with CNB could be helpful for arriving at a clinical decision in patients with thyroid nodules showing AUS in a previous cytology.