Thyroid Nodules 101: Indeterminate Biopsy Can Now collect Molecular Markers Without a Repeat Biopsy
Repeat FNA for thyroid indeterminate results used to require another biopsy to collect the marker.
No more as several DNA labs have a way to do the testing on the original slides for the first biopsy if there are adequate cells.. Interpace does micro-dissection for makers and classifiers.
Interpace’s Syd Finkelstein has deveopled this cool way to save you another biopsy just to collect markers.
My paper on slide scratch off for nucleic acid molecular markers was presented at the World Thyroid Cancer Congress July 2017 in Boston
MICRO-DISSECTION EXTRACTED NUCLEIC ACID MOLECULAR MARKER TESTING: A CASE
Thyroid Slide Microdissection: Stained cytology slides had their coverslips removed by soaking in xylene after which serial alcohol washes were carried and the stained slides air-dried. Microdissection was performed manually under stereoscopic guidance. The microdissected cellular material was collected in dilute Tris buffer.
1. Prior biopsy slides can be tested for molecular markers and classifier by this new technique. 2. If this method becomes universally available for clinical practice it can reduce the number of repeat biopsies to obtain molecular markers. 3 The needle washout method may not be needed in the future. 4. Liquid based thyroid biopsy samples are not suitable for testing at present. 5. This will reduce the patient’s anxiety when another biopsy is not needed.
RICHARD GUTTLER MD, FACE, ECNU
INTERVENTIONAL THYROID CENTER
SANTA MONICA THYROID SANTA MONICA CALIFORNIA USA
Also according to a recent study there is no need to wait 3 months if the first biopsy is inadequate.
Delaying repeat thyroid fine-needle aspiration (FNA) for 3 mo after a non diagnostic result is not associated with improved diagnostic yield for thyroid cancer.
Patients who received early (3 mo) repeat FNA had similar satisfactory diagnosis yield (84.4% vs 90.9%; P=.117).
Early and late repeat FNA were associated with similar specificity (100% for both) and sensitivity (44.44% vs 51.85%; P=.7631).
Repeat FNA was non diagnostic in 11.04% of patients.
17.6% of patients who had a non diagnostic result on repeat biopsy were found to have malignancy after diagnostic lobectomy.
Don’t have another biopsy just to collect DNA markers.
We can do micro-dissection on your original slides.
Call Matt at 310-393-8860 and bring your original slides and I can save you another biopsy.