Dr. Nikiforov on Molecular Testing of Thyroid Nodules

Yuri E. Nikiforov, MD, PhD, Director of the Division of Molecular Anatomic Pathology, Department of Pathology, University of Pittsburgh, believes that one of the most exciting new developments in the treatment of thyroid cancer is the identification of novel oncogenes that can be applied to the management of patients with thyroid nodules.

Nikiforov explains that thyroid nodules are very common in the general population; however, less than 5% of nodules are cancerous. Determining if a nodule is malignant and requires surgery has traditionally been assessed using a fine-needle aspiration biopsy that is examined under a microscope. On average, 1 in 5 of these assessments result in an indeterminate diagnosis and potentially unnecessary diagnostic surgical interventions.

To prevent unneeded surgery, a new molecular panel has been developed that reviews the fine-needle aspiration cytology for thyroid specific oncogenes, such as BRAF, RAS, and RET/PTC. This panel provides a more accurate preoperative assessment tool for thyroid nodules allowing for appropriate surgical intervention based on molecular aberrations.

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