Molecular Mutations and Clinical Behavior in Bethesda III and IV Thyroid Nodules
Author Information
Author(s): Payne Alexandra E., Lefebvre Coralie, Minello Michael, Rajab Mohannad, da Silva Sabrina Daniela, Pusztaszeri Marc, Hier Michael P., Forest Veronique-Isabelle, Spinelli Claudio, Ghionzoli Marco
Primary Institution: McGill University
Hypothesis
This study aims to identify and compare the frequency of molecular alterations in Bethesda III and IV thyroid nodules and to determine if these differences correlate with tumor invasiveness/aggressiveness or malignancy.
Conclusion
Molecular profiling can help differentiate between the clinical behaviors of Bethesda III and IV thyroid nodules, suggesting that testing may be more important for Bethesda III nodules.
Supporting Evidence
- Bethesda IV nodules exhibited a higher prevalence of copy number alterations and distinct gene expression profiles compared to Bethesda III nodules.
- The BRAFV600E mutation was found exclusively in Bethesda III nodules, correlating with more aggressive malignant behavior.
- 79% of Bethesda III nodules and 84% of Bethesda IV nodules were malignant/NIFTP after final pathology.
Takeaway
This study looked at thyroid nodules that are hard to classify and found that some have specific mutations that can help doctors decide how to treat them better.
Methodology
The study retrospectively analyzed data from 203 patients with Bethesda III and IV thyroid nodules who underwent ThyroSeq v3 molecular testing followed by thyroid surgery.
Potential Biases
Potential selection bias due to financial barriers affecting which patients underwent molecular testing.
Limitations
The retrospective design limits the strength of the findings, and the study was conducted at a single institution, which may introduce selection bias.
Participant Demographics
Average age for Bethesda III nodules was 54.4 years, and for Bethesda IV, it was 51.9 years; 76.9% of Bethesda III patients were female and 84.9% of Bethesda IV patients were female.
Statistical Information
P-Value
p = 0.009
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
Want to read the original?
Access the complete publication on the publisher's website