Xiaoyin Jiang

Overview:

I am a pathologist specializing in cytopathology and surgical pathology. I diagnose diseases through integrating clinical history and studying patient samples under the microscope. As a cytopathologist, I perform fine needle aspiration biopsies in our clinic. I serve as Associate Director of the Duke Biorepository and Precision Pathology Center (BRPC). The Duke BRPC is the largest broad consent biobanking protocol and human tissue repository on campus.  It also provides specialty tissue processing services including histology, immunohistochemistry, and tissue microarray.
My research interests focus on the pathology of the head and neck and endocrine systems, working with a multidisciplinary team to improve our understanding of disease. I also focus on novel applications of social media for physicians and medical education.

Positions:

Associate Professor of Pathology

Pathology
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 2009

Duke University School of Medicine

Resident, Pathology

Duke University School of Medicine

Fellow, Cytopathology

Duke University School of Medicine

Grants:

Publications:

Hurthle cell predominance impacts results of Afirma gene expression classifier and ThyroSeq molecular panel performance in indeterminate thyroid nodules.

BACKGROUND: Molecular tests such as the Afirma gene expression classifier (GEC) and mutational panels (such as ThyroSeq) have been introduced to help risk stratify cytologically indeterminate thyroid nodules with the aim to reduce the number of unnecessary thyroidectomies. Some reports have suggested that samples with Hurthle cell predominance have higher false-positive rates on GEC testing, but data are limited. METHODS: We reviewed thyroid nodules with indeterminate (Bethesda III/IV) cytology at our institution. Patient demographics, cytologic and histologic diagnoses (where available), and molecular test results were collected. RESULTS: GEC was performed on 202 nodules, and ThyroSeq was performed on 81 nodules. In the GEC cohort, 66% of nodules with Hurthle cell predominance yielded "suspicious" result vs 46% of nodules without Hurthle cell predominance, with risk of malignancy (ROM) for surgically resected nodules of 16% and 33%, respectively. In ThyroSeq cohort, 8% of nodules with Hurthle cell predominance yielded a high-risk mutation vs 19% of nodules without Hurthle cell predominance, with ROM of 50% and 33%, respectively. CONCLUSIONS: For ThyroSeq molecular panel, while it did not appear that there was an increase in rate of high-risk mutations detected in the samples with Hurthle cell predominance, small numbers limit the generalizability of these results. For the GEC cohort, indeterminate thyroid nodules with predominance of Hurthle cells showed an increased rate of "suspicious" results compared to samples without Hurthle cell predominance. The ROM for GEC "suspicious" nodules with Hurthle cell predominance on surgical resection was lower in our study. Repeat FNA may be of use in patients with these types of nodules. In the context of a Hurthle cell predominant lesion, positive results on molecular testing may not carry a high rate of malignancy.
Authors
Parajuli, S; Jug, R; Ahmadi, S; Jiang, XS
MLA Citation
Parajuli, Shobha, et al. “Hurthle cell predominance impacts results of Afirma gene expression classifier and ThyroSeq molecular panel performance in indeterminate thyroid nodules..” Diagn Cytopathol, vol. 47, no. 11, Nov. 2019, pp. 1177–83. Pubmed, doi:10.1002/dc.24290.
URI
https://scholars.duke.edu/individual/pub1402723
PMID
31348619
Source
pubmed
Published In
Diagn Cytopathol
Volume
47
Published Date
Start Page
1177
End Page
1183
DOI
10.1002/dc.24290

Innovations: Brave new worlds.

Authors
Jiang, XS; Madrigal, E
MLA Citation
Jiang, Xiaoyin Sara, and Emilio Madrigal. “Innovations: Brave new worlds..” Cancer Cytopathol, vol. 127, no. 8, Aug. 2019, pp. 491–92. Pubmed, doi:10.1002/cncy.22141.
URI
https://scholars.duke.edu/individual/pub1396149
PMID
31150154
Source
pubmed
Published In
Cancer Cytopathol
Volume
127
Published Date
Start Page
491
End Page
492
DOI
10.1002/cncy.22141

Negative Results on Thyroid Molecular Testing Decrease Rates of Surgery for Indeterminate Thyroid Nodules.

Molecular tests and mutational panels such as Afirma Gene Expression Classifier (GEC) and ThyroSeq, respectively, have been used to help risk stratify cytologically indeterminate thyroid nodules with the aim to reduce unnecessary surgeries. We studied the effect of molecular testing on the rate of surgical resection in these nodules. Thyroid nodules with indeterminate (Bethesda III/IV) cytology that underwent molecular testing (GEC or ThyroSeq) at our institution between June 2012 and August 2016 were retrospectively reviewed. We collected demographics, cytology diagnoses, molecular test results, and whether surgical resection was performed. Two hundred eighty-three nodules met inclusion criteria: 202 nodules tested with GEC and 81 tested with ThyroSeq. In the cohort of GEC-tested nodules, 99/202 (49%) yielded "suspicious" and 103/202 (51%) yielded "benign" results, with an overall resection rate of 70/99 (71%) in "suspicious" versus 13/103 (13%) in "benign" nodules. In the cohort of ThyroSeq-tested nodules, 13/81 (16%) of nodules yielded a "high-risk mutation" and 68/81 (84%) of nodules yielded "no high-risk mutation," with overall resection rates of 11/13 (85%) and 30/68 (44%), respectively. Rates of resection were higher for Bethesda IV than for III nodules, regardless of molecular results. For both GEC and ThyroSeq, molecular test results seemed to correlate with the rate of resection at our institution. Rates of resection for cytologically indeterminate nodules that were "benign" or "no high-risk mutation" appeared to differ from those that were "suspicious" or "high-risk mutation" on molecular panel testing by GEC and ThyroSeq, respectively. Our findings support that molecular test results are impacting management.
Authors
Jug, R; Parajuli, S; Ahmadi, S; Jiang, XS
MLA Citation
Jug, Rachel, et al. “Negative Results on Thyroid Molecular Testing Decrease Rates of Surgery for Indeterminate Thyroid Nodules..” Endocr Pathol, vol. 30, no. 2, June 2019, pp. 134–37. Pubmed, doi:10.1007/s12022-019-9571-x.
URI
https://scholars.duke.edu/individual/pub1373852
PMID
30825100
Source
pubmed
Published In
Endocr Pathol
Volume
30
Published Date
Start Page
134
End Page
137
DOI
10.1007/s12022-019-9571-x

A Rare Case of Malignant Transformation of Oral Lichen Planus of the Mandible.

Oral lichen planus (OLP) is an immune-mediated mucocutaneous disease associated with an increased risk in oral squamous cell carcinoma (OSCC). Nearly all cases of malignant transformation have been reported in patients >40 years old. We report the case of a 37-year-old woman with a 5-year history of erosive OLP who presented with malignant transformation to OSCC. Delineating the margins of the disease was impossible at presentation given her OLP, and she was initially treated with concurrent chemoradiation therapy. She then developed a recurrence of the mandibular alveolar ridge. The patient was successfully treated with a composite resection including a segmental mandibulectomy, buccal mucosa resection, partial glossectomy, and ipsilateral neck dissection. This was reconstructed with a free fibula osteo-septo-cutaneous flap. Mandibular OSCC is a rare complication of OLP with few reports on effective reconstructive interventions. The case represents the youngest reported patient with mandibular OSCC arising in the context of OLP and highlights the utility of the free vascularized fibula graft in the treatment of these patients.
Authors
Soo, J; Kokosis, G; Ogilvie, M; Sara Jiang, X; Powers, DB; Rocke, DJ; Erdmann, D
MLA Citation
Soo, Joanne, et al. “A Rare Case of Malignant Transformation of Oral Lichen Planus of the Mandible..” Plast Reconstr Surg Glob Open, vol. 4, no. 12, Dec. 2016. Pubmed, doi:10.1097/GOX.0000000000001070.
URI
https://scholars.duke.edu/individual/pub1241492
PMID
28293492
Source
pubmed
Published In
Plastic and Reconstructive Surgery Global Open
Volume
4
Published Date
Start Page
e1070
DOI
10.1097/GOX.0000000000001070

Phase I trial of temozolomide plus O6-benzylguanine on three different 5-day temozolomide regimens for patients with progressive glioblastoma multiforme

Authors
Quinn, JA; Jiang, XS; Rich, JN; Desjardins, A; Vredenburgh, JJ; Reardon, DA; Gururangan, S; Walker, AR; Birch, R; Friedman, AH; Friedman, HS
MLA Citation
Quinn, J. A., et al. “Phase I trial of temozolomide plus O6-benzylguanine on three different 5-day temozolomide regimens for patients with progressive glioblastoma multiforme.” Journal of Clinical Oncology, vol. 26, no. 15_suppl, American Society of Clinical Oncology (ASCO), May 2008, pp. 2084–2084. Crossref, doi:10.1200/jco.2008.26.15_suppl.2084.
URI
https://scholars.duke.edu/individual/pub874910
Source
crossref
Published In
Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology
Volume
26
Published Date
Start Page
2084
End Page
2084
DOI
10.1200/jco.2008.26.15_suppl.2084

Research Areas:

Cytopathology
Needle biopsy
Pathology
Pathology, Molecular
Pathology, Oral
Pathology, Surgical
Social Media
Thyroid Neoplasms
Thyroid Nodule