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Lithwick-Yanai G, Dromi N, Shtabsky A, Morgenstern S, Strenov Y, Feinmesser M, Kravtsov V, Leon ME, Hajdúch M, Ali SZ, VandenBussche CJ, Zhang X, Leider-Trejo L, Zubkov A, Vorobyov S, Kushnir M, Goren Y, Tabak S, Kadosh E, Benjamin H, Schnitzer-Perlman T, Marmor H, Motin M, Lebanony D, Kredo-Russo S, Mitchell H, Noller M, Smith A, Dattner O, Ashkenazi K, Sanden M, Berlin KA, Bar D, Meiri E. Multicentre validation of a microRNA-based assay for diagnosing indeterminate thyroid nodules utilising fine needle aspirate smears. J Clin Pathol 2016; 70:500-507. [PMID: 27798083 PMCID: PMC5484037 DOI: 10.1136/jclinpath-2016-204089] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 10/05/2016] [Accepted: 10/06/2016] [Indexed: 12/20/2022]
Abstract
AIMS The distinction between benign and malignant thyroid nodules has important therapeutic implications. Our objective was to develop an assay that could classify indeterminate thyroid nodules as benign or suspicious, using routinely prepared fine needle aspirate (FNA) cytology smears. METHODS A training set of 375 FNA smears was used to develop the microRNA-based assay, which was validated using a blinded, multicentre, retrospective cohort of 201 smears. Final diagnosis of the validation samples was determined based on corresponding surgical specimens, reviewed by the contributing institute pathologist and two independent pathologists. Validation samples were from adult patients (≥18 years) with nodule size >0.5 cm, and a final diagnosis confirmed by at least one of the two blinded, independent pathologists. The developed assay, RosettaGX Reveal, differentiates benign from malignant thyroid nodules, using quantitative RT-PCR. RESULTS Test performance on the 189 samples that passed quality control: negative predictive value: 91% (95% CI 84% to 96%); sensitivity: 85% (CI 74% to 93%); specificity: 72% (CI 63% to 79%). Performance for cases in which all three reviewing pathologists were in agreement regarding the final diagnosis (n=150): negative predictive value: 99% (CI 94% to 100%); sensitivity: 98% (CI 87% to 100%); specificity: 78% (CI 69% to 85%). CONCLUSIONS A novel assay utilising microRNA expression in cytology smears was developed. The assay distinguishes benign from malignant thyroid nodules using a single FNA stained smear, and does not require fresh tissue or special collection and shipment conditions. This assay offers a valuable tool for the preoperative classification of thyroid samples with indeterminate cytology.
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Affiliation(s)
| | - Nir Dromi
- Rosetta Genomics Ltd, Rehovot, Israel
| | - Alexander Shtabsky
- Pathology Institute, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.,The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Sara Morgenstern
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Pathology Institute, Rabin Medical Center, Petach Tikva, Israel
| | - Yulia Strenov
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Pathology Institute, Rabin Medical Center, Petach Tikva, Israel
| | - Meora Feinmesser
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Pathology Institute, Rabin Medical Center, Petach Tikva, Israel
| | - Vladimir Kravtsov
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Pathology Institute, Meir Medical Center, Kfar Saba, Israel
| | - Marino E Leon
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Marián Hajdúch
- Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Syed Z Ali
- The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Xinmin Zhang
- Temple University Hospital, Philadelphia, Pennsylvania, USA.,Cooper University Hospital, Cooper Medical School of Rowan University at Camden, New Jersey, USA
| | - Leonor Leider-Trejo
- Pathology Institute, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.,The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Asia Zubkov
- Pathology Institute, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Sergey Vorobyov
- National Centre of Clinical and Morphological Diagnostics, St Petersburg, Russia
| | | | - Yaron Goren
- Rosetta Genomics Ltd, Rehovot, Israel.,Geha Mental Health Center, Petach Tikva, Israel
| | | | | | - Hila Benjamin
- Rosetta Genomics Inc, Philadelphia, Pennsylvania, USA
| | | | | | | | | | | | | | | | - Alexis Smith
- Rosetta Genomics Inc, Philadelphia, Pennsylvania, USA
| | | | | | - Mats Sanden
- Rosetta Genomics Inc, Philadelphia, Pennsylvania, USA
| | | | | | - Eti Meiri
- Rosetta Genomics Ltd, Rehovot, Israel
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