Lisanne de Koster

467 A clinically applicable molecular classification of oncocytic cell thyroid nodules 11 include a wider range of neoplastic or non-neoplastic thyroid and parathyroid disorders that present with oncocytic changes, to confirm the absence of OCN-characteristic CNA in these diagnoses. Validation studies from our study group are currently in progress, including molecular diagnostics of the prospective EfFECTS trial cohort (ClinicalTrials.gov: NCT02208544)[501] and a separate prospective trial on preoperative risk stratification of cytologically indeterminate thyroid nodules using molecular diagnostics. Both include non-oncocytic and oncocytic nodules. In addition, it currently remains unknown whether more accurate differentiation and risk stratification of OCN using molecular diagnostics, including consequent treatment decisions, finally improves the prognosis of OCA. This requires data that is not yet available, i.e., from large cohort studies with molecular diagnostics and follow-up extending over several decades. Finally, cost-effectiveness should be taken into consideration and formal cost-utility studies should be performed in the future. The joint costs of our molecular panels are approximately €1,350 ($1,479; $1=€0.91 on 02-05-2023) per patient with an OCN. In conclusion, the results of this study demonstrate that CNA-LOH analysis using a limited, 1,500 SNP NGS panel is a feasible method for CNA-LOH analysis in OCN in everyday clinical practice. The results of this study, including full description of the CNA patterns that may be distinguished and considerations for their structured interpretation to establish a molecular diagnosis, may aid the widespread application of CNA-LOH analysis for the preoperative as well as postoperative diagnosis and risk stratification of oncocytic cell lesions.

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