Value of sonographic features in predicting malignancy in thyroid nodules diagnosed as follicular neoplasm on cytology
Value of sonographic features in predicting malignancy in thyroid nodules diagnosed as follicular neoplasm on cytology
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DOI：
10.1111/cen.12692
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发表时间：
2015-11-01
影响因子：
3.2
通讯作者：
Beale, Tim
中科院分区：
文献类型：
--
作者：
Chng, Chiaw-Ling;Kurzawinski, Tom R.;Beale, Tim
背景滤泡性肿瘤（Thy 3F）的细胞学诊断仍是一个挑战。本研究的主要目的是分层甲状腺结节恶性肿瘤的风险诊断为Thy 3F细胞学（Thy 3F）使用甲状腺成像报告和数据系统（TIRADS.MethodsA数据库的甲状腺结节与Thy 3F细胞学结果从超声引导FNA（US-FNA）2007年1月至2014年3月进行了回顾性研究。收集患者的人口统计学资料、超声特征和结节的最终组织学。根据TIRADS计数每个甲状腺结节可疑超声特征的数量。每个TIRADS类别的恶性肿瘤率也计算的结节的最终组织学结果的基础上，并使用最近提出的甲状腺恶性肿瘤的风险预测model.ResultsThe整体恶性肿瘤率的Thy 3F细胞学的计算相比，为243%。与良性结节相比，恶性结节具有不规则边缘（200%比0%，P=0000）、低回声（743%比514%，P=0013）和高宽形态（171%比09%，P=0001）的百分比显著较高。恶性肿瘤的风险随着TIRADS评分的提高而增加：TIRADS 4A（143%）、TIRADS 4 B（231%）、TIRADS 4C（875%）和TIRADS 5（100%）。TIRADS评分越高，恶性率越高：TIRADS 4A（6 2%）、TIRADS 4 B（32 5%）、TIRADS 4C（79 9%）、TIRADS 5（90%）。结论TIRADS评分为4C、5分的甲状腺结节恶性率高，应考虑行一次性根治性手术。
BackgroundThe cytological diagnosis of follicular neoplasm (Thy3F) remains a diagnostic challenge. The main aim of this study was to stratify the risk of malignancy in thyroid nodules diagnosed as Thy3F on cytology (Thy3F) using thyroid imaging reporting and data system (TIRADS).MethodsA database of thyroid nodules with Thy3F cytological results from ultrasound-guided FNA (US-FNA) between January 2007 and March 2014 was studied retrospectively. Information on patient demographics, ultrasound characteristics and final histology of the nodules was collated. The number of suspicious US features of each thyroid nodule was counted based on TIRADS. The malignancy rate of each of the TIRADS category was also calculated based on the final histological outcomes of the nodules and compared to that calculated using a recently proposed thyroid malignancy risk prediction model.ResultsThe overall malignancy rate of Thy3F cytology was 243%. There were significantly higher percentages of malignant nodules with irregular margins (200% vs 0%, P=0000), hypo-echogenicity (743% vs 514%, P=0013) and taller-than-wide morphology (171% vs 09%, P=0001) when compared to benign nodules. The risk of malignancy increased with advancing TIRADS score: TIRADS 4A (143%), TIRADS 4B (231%), TIRADS 4C (875%) and TIRADS 5 (100%). The malignancy rate calculated using the prediction model similarly increased with advancing TIRADS score: TIRADS 4A (62%), TIRADS 4B (325%), TIRADS 4C (799%) and TIRADS 5 (90%).ConclusionThyroid nodules with TIRADS scores 4C and 5 should be considered for single definitive surgery in view of the high malignant rate.