# Afirma Genomic Sequencing Classifier and Xpression Atlas Molecular Findings in Consecutive Bethesda III-VI Thyroid Nodules

Source: https://onco.cc/key-papers/paper-hu-afirma-xpression-atlas-j-clin-endocrinol-metab-2021/  
OnCo record `paper-hu-afirma-xpression-atlas-j-clin-endocrinol-metab-2021` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

An analysis of more than 50,000 thyroid nodules tested with Afirma's RNA classifier and its variant and fusion panel, showing how often a genomic change was found.

## Summary

In 50,644 nodules, at least one genomic alteration was identified by the expanded Xpression Atlas panel in 44 per cent of Bethesda III or IV nodules that the classifier called suspicious and in 87 per cent of Bethesda VI aspirates.

## Fields

- Kind: Key paper
- Last checked: 2026-11-04
- Journal: Journal of Clinical Endocrinology and Metabolism
- Year: 2021
- DOI: 10.1210/clinem/dgab304
- Authors: Hu MI, Waguespack SG, Dosiou C, et al.
- Findings: Genomic alteration in 44% of suspicious Bethesda III/IV and 87% of Bethesda VI nodules.
- What it means: RNA sequencing of a thyroid aspirate can also report the mutation or fusion behind a suspicious nodule.
- Caveats: Laboratory database analysis without surgical outcomes for all nodules.

## Sources

- Hu et al., J Clin Endocrinol Metab 2021: https://doi.org/10.1210/clinem/dgab304
- PubMed: https://pubmed.ncbi.nlm.nih.gov/34009369/

## Connected records

- cancers: [Thyroid cancer](https://onco.cc/cancers/thyroid/)
- fronts: [Diagnostics & Biomarkers](https://onco.cc/fronts/diagnostics/)
- technologies: [RNA sequencing & expression profiling](https://onco.cc/technologies/rna-seq/), [Thyroid nodule FNA, Bethesda cytology & molecular classifiers](https://onco.cc/technologies/thyroid-fna-molecular/)
- drugs: [Afirma Genomic Sequencing Classifier](https://onco.cc/drugs/afirma/)
- terms: [Biomarker](https://onco.cc/terms/biomarker/)

---
JSON: https://onco.cc/api/v1/entities/paper-hu-afirma-xpression-atlas-j-clin-endocrinol-metab-2021.json