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Chemistry is the study of matter and the changes it undergoes. Matter is anything that has mass and occupies space. Matter is all around us; the air, water, soil, mountains, even our bodies are all examples of matter. Matter is divided into three states — solid, liquid, and gas — that are commonly found on earth. The fourth state of matter, plasma, occurs naturally in the interiors of stars. 
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Related Experiment Video

Updated: Jan 24, 2026

Using an Automated Cell Counter to Simplify Gene Expression Studies: siRNA Knockdown of IL-4 Dependent Gene Expression in Namalwa Cells
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Afirma Gene Sequencing Classifier Compared with Gene Expression Classifier in Indeterminate Thyroid Nodules.

Mayumi Endo1, Fadi Nabhan1, Kyle Porter2

  • 11Division of Endocrinology, Diabetes, and Metabolism; The Ohio State University and Arthur G. James Cancer Center, Columbus, Ohio.

Thyroid : Official Journal of the American Thyroid Association
|June 4, 2019
PubMed
Summary
This summary is machine-generated.

The Afirma Gene Sequencing Classifier (GSC) shows higher accuracy for indeterminate thyroid nodules than the Gene Expression Classifier (GEC). GSC significantly reduces unnecessary surgeries, improving patient outcomes and healthcare efficiency.

Keywords:
Afirmaindeterminate thyroid nodulesmolecular diagnostic testing

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Area of Science:

  • Endocrinology
  • Oncology
  • Molecular Diagnostics

Background:

  • Cytologically indeterminate (cyto-I) thyroid nodules require further characterization.
  • The Afirma Gene Expression Classifier (GEC) has limitations, including a low positive predictive value (PPV).
  • The Afirma Gene Sequencing Classifier (GSC) was developed to enhance PPV while maintaining high negative predictive value (NPV).

Purpose of the Study:

  • To assess the real-world performance of the Afirma Gene Sequencing Classifier (GSC) compared to the Afirma Gene Expression Classifier (GEC).
  • To evaluate the impact of GSC on diagnostic accuracy and surgical intervention rates for indeterminate thyroid nodules.

Main Methods:

  • Retrospective analysis of patients with cyto-I thyroid nodules undergoing molecular testing (GEC or GSC) between 2011 and 2018.
  • Comparison of diagnostic metrics including benign call rate, PPV, NPV, and specificity between GEC and GSC.
  • Analysis of surgical intervention rates before and after the implementation of GSC.

Main Results:

  • GSC demonstrated a significantly higher benign call rate (76.2% vs. 48.1%), PPV (60.0% vs. 33.3%), and specificity (94.3% vs. 61.4%) compared to GEC.
  • These improvements were significant for both Bethesda III and IV nodules, including those with Hürthle cell changes.
  • Surgical intervention rates decreased by 66.4% after switching to GSC (17.6% vs. 52.5% with GEC).

Conclusions:

  • The Afirma Gene Sequencing Classifier (GSC) offers improved specificity and PPV for indeterminate thyroid nodules compared to GEC, while maintaining high sensitivity and NPV.
  • GSC leads to a significant increase in benign call rates, suggesting fewer false positives.
  • Implementation of GSC has substantially reduced surgical interventions for indeterminate thyroid nodules.