Genetic markers differentiating follicular thyroid carcinoma from benign lesions

Thyroid nodules are commonly encountered during routine medical care. The main problem established by a discovery of a thyroid nodule is to discriminate between a benign and malignant lesion. Fine-needle aspiration (FNA) is the most widely used and cost-effective preoperative test for initial evaluation of a thyroid nodule. While the overall accuracy of FNA for classical papillary thyroid carcinoma (PTC) approaches 100%, it has limited accuracy with follicular lesions. Patients with a cytological report of indeterminate or follicular lesions are referred to surgery for a more accurate diagnosis. A more acute molecular-based test for thyroid nodules is needed not only to improve treatment decisions, but also to potentially reduce the long-term health costs. Several studies have looked into biologic markers that could be used as an adjuvant to distinguish the benign from malignant nodules. This review will focus on those biomarkers that are potentially useful in the diagnosis of thyroid lesions commonly classified as indeterminate. (C) 2009 Elsevier Ireland Ltd. All rights reserved.