By fine-tuning “fine-needle aspiration” biopsies with a super-fast genetic microarray technology, a team of surgeons from NewYork-Presbyterian Hospital/Weill Cornell Medical Center in New York City says they can greatly enhance the accuracy of these tests.
“For patients with worrisome thyroid nodules, this means better information on whether the nodule is malignant or benign. That should help them and their doctors make better decisions as to what treatment they’d like to pursue,” explains senior researcher Dr. Thomas J. Fahey III, associate professor of surgery and Frank Glenn Faculty Scholar in Surgery at Weill Cornell Medical College, and associate attending surgeon at NewYork-Presbyterian Hospital/Weill Cornell Medial Center in New York City.
In the study, the team created microarray-generated “gene expression profiles” from fine-needle aspirates by comparing the expression of thousands of genes from both cancerous and benign thyroid tissues. This process ended in a grouping of 25 differently expressed genes that helped distinguish malignant from benign growths.
“We next tested the accuracy of these patterns using 22 fine-needle aspirate samples from benign or malignant thyroid nodules,” Dr. Lubitz explained.
“In all but one case, the microarray test agreed completely with the results of extensive histological analysis in the lab,” she said.
According to the researchers, a move from histological to microarray analysis of thyroid aspirates could impact anywhere from 5 to 25 percent of patients undergoing this kind of diagnosis — giving them a better grasp of whether they might require surgery, for example.
Cost remains a factor, with a single microarray screen currently totaling about $500. “We anticipate, however, that as this technology becomes more widespread and improves, the price per test will fall much lower,” Dr. Fahey says.