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Related Experiment Videos

The first Canadian experience with the Afirma® gene expression classifier test.

Emily Kay-Rivest1, Jamie Tibbo2, Sarah Bouhabel1

  • 1Department of Otolaryngology - Head and Neck Surgery, McGill University, Jewish General Hospital, 3755 Côte-Sainte-Catherine Road, Montréal, QC, H3T 1E2, Canada.

Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'Oto-Rhino-Laryngologie Et De Chirurgie Cervico-Faciale
|April 5, 2017
PubMed
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The Afirma® gene expression classifier (AGEC) effectively identifies suspicious thyroid nodules, showing consistent malignancy rates across Canadian centers. This molecular test aids in managing indeterminate thyroid nodules, aligning with international findings.

Area of Science:

  • Endocrinology
  • Oncology
  • Molecular Diagnostics

Background:

  • Thyroid nodules are common, with 5-15% being malignant.
  • Ultrasound-guided fine-needle aspiration (USFNA) yields indeterminate results in 15-30% of cases.
  • The Afirma® gene expression classifier (AGEC) was developed to aid in managing indeterminate thyroid nodules (ITNs).

Purpose of the Study:

  • Assess AGEC performance in two Canadian academic medical centers.
  • Investigate inter-institutional variation in AGEC results.
  • Compare Canadian AGEC performance with reported American data.

Main Methods:

  • Retrospective cohort study of patients with indeterminate cytopathology (Bethesda Class III or IV).
  • Included patients undergoing USFNA and AGEC testing.
Keywords:
Afirma® Gene Expression ClassifierIndeterminate thyroid nodulesMolecular testingThyroid cancerUltrasound-guided fine-needle aspiration

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  • Reviewed demographics, cytopathology, AGEC, and final surgical pathology results.

    • Main Results:

    • 172 patients with indeterminate thyroid nodules were analyzed (109 Montreal, 63 St. John's).
    • "Benign" results varied by institution (55% Montreal, 46% St. John's); no surgeries performed.
    • "Suspicious" results (45% Montreal, 54% St. John's) led to surgery, with ~50% confirmed malignancy in both centers.

    Conclusions:

    • AGEC testing shows consistent performance in identifying malignancy in suspicious thyroid nodules across Canadian centers.
    • Inter-institutional variability exists in "benign" classification rates.
    • Canadian AGEC performance aligns with previously reported data from American institutions.