A gene expression classifier (GEC) test is a developing technology in the analysis of indeterminate thyroid nodules, using cells from a fine needle aspiration. The most common commercially available GEC in the United States is known as AFIRMA.
The test is designed to use molecular markers to help classify "indeterminate" thyroid nodules, and therefore avoid surgery for indeterminate nodules that are actually benign.
If the GEC test result is benign then the sensitivity of the test is high enough to achieve a negative predictive value of 94-95% in:
- atypical or follicular lesion of undetermined significance
- follicular neoplasm or lesion suggestive of follicular neoplasm
The GEC test does not have a role when there is a definitive result (either benign or malignant) on the original FNA aspiration.
- 1. Ali SZ, Fish SA, Lanman R et-al. Use of the afirma® gene expression classifier for preoperative identification of benign thyroid nodules with indeterminate fine needle aspiration cytopathology. PLoS Curr. 2013;5: . doi:10.1371/currents.eogt.e557cbb5c7e4f66568ce582a373057e7 - Free text at pubmed - Pubmed citation
- 2. Duick DS, Klopper JP, Diggans JC et-al. The impact of benign gene expression classifier test results on the endocrinologist-patient decision to operate on patients with thyroid nodules with indeterminate fine-needle aspiration cytopathology. Thyroid. 2012;22 (10): 996-1001. doi:10.1089/thy.2012.0180 - Free text at pubmed - Pubmed citation
- 3. Jameson JL. Minimizing unnecessary surgery for thyroid nodules. N. Engl. J. Med. 2012;367 (8): 765-7. doi:10.1056/NEJMe1205893 - Pubmed citation
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