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Rano E, Lin L, Molinie V, Sulpicy C, Dorival MJ, Drak Alsibai K, Nacher M, Drame M, Sabbah N. Epidemiological, Clinical, Ultrasonographic and Cytological Characteristics of Thyroid Nodules in an Afro-Caribbean Population: A Series of 420 Patients. Cancers (Basel) 2022; 14:cancers14102365. [PMID: 35625970 PMCID: PMC9139893 DOI: 10.3390/cancers14102365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/16/2022] [Accepted: 04/19/2022] [Indexed: 11/25/2022] Open
Abstract
Simple Summary This study describes the epidemiological, clinical and ultrasound characteristics of malignancy in thyroid nodules and evaluates the value of cytology in the diagnosis of malignancy in an Afro-Caribbean population. Our results revealed that none of the standard ultrasound criteria of malignancy were significantly predictive of cancer, but hypoechogenicity and central vascularity were frequently found in malignant nodules. These results could increase awareness and guide practitioners in their diagnostic approach and management of thyroid nodules in Afro-Caribbean populations. Bethesda system-based cytology revealed low sensitivity in analyzing the risk of malignancy in this population. The high prevalence of papillary microcarcinomas may explain the inconclusive ultrasound and cytological results. Abstract The incidence of thyroid cancer is increasing worldwide. The aim of this study is to describe the epidemiological, clinical and ultrasound characteristics of malignancy in thyroid nodules and to evaluate the predictive value of the Bethesda system for thyroid cytology in the diagnosis of malignancy in an Afro-Caribbean population. We conducted a retrospective study in Martinique involving 420 patients with a diagnosis of thyroid nodules between 2011 and 2014. Of the 192/420 (45.7%) patients operated on for thyroid nodules, 9% had thyroid cancer. All patients with thyroid cancer were obese women with a mean age of 50 years. The final histological examination revealed papillary microcarcinomas in 61% of cases and papillary carcinomas in 39% of cases. Thyroid cytology alone had a low sensitivity (22.2%) and positive predictive value (15.4%) for the diagnosis of malignancy, with a good specificity (91.1%) and negative predictive value (94.2%). None of the standard ultrasound criteria of malignancy were significantly predictive of cancer, but hypoechogenicity and central vascularity were frequently found in malignant nodules. These epidemiological, clinical and ultrasound results could increase awareness and guide practitioners in their diagnostic approach and management of thyroid nodules in an Afro-Caribbean population. Bethesda system-based cytology revealed lower sensitivity in analyzing the risk of malignancy in this population. The high prevalence of papillary microcarcinomas may explain the inconclusive ultrasound and cytological results.
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Affiliation(s)
- Elodie Rano
- Department of Endocrinology and Metabolic Diseases, University Hospital Centre Louis Domergues, F-97220 La Trinité, France; (E.R.); (L.L.)
| | - Lucien Lin
- Department of Endocrinology and Metabolic Diseases, University Hospital Centre Louis Domergues, F-97220 La Trinité, France; (E.R.); (L.L.)
| | - Vincent Molinie
- Department of Pathology, University Hospital Centre Pierre Zobda Quitman, F-97261 Fort-de-France, France;
| | | | | | - Kinan Drak Alsibai
- Centre of Biological Resources (CRB Amazonie), Cayenne Hospital Centre, F-97306 Cayenne, French Guiana;
- Clinical Investigation Center Antilles-French Guiana (CIC, INSERM 1424) Cayenne Hospital Centre Andrée Rosemon, F-97306 Cayenne, French Guiana;
| | - Mathieu Nacher
- Clinical Investigation Center Antilles-French Guiana (CIC, INSERM 1424) Cayenne Hospital Centre Andrée Rosemon, F-97306 Cayenne, French Guiana;
| | - Moustafa Drame
- Department of Medical Information, University Hospital Centre Pierre Zobda Quitman, F-97261 Fort-de-France, France;
| | - Nadia Sabbah
- Clinical Investigation Center Antilles-French Guiana (CIC, INSERM 1424) Cayenne Hospital Centre Andrée Rosemon, F-97306 Cayenne, French Guiana;
- Department of Endocrinology and Metabolic Diseases, Cayenne Hospital Centre Andrée Rosemon, F-97306 Cayenne, French Guiana
- Correspondence: ; Tel.: +(594)-0594395276
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Fine-needle aspiration cytology repetition in thyroid nodules with non-diagnostic findings or atypia of undetermined significance/follicular lesions of undetermined significance: Does time matters? ANNALES D'ENDOCRINOLOGIE 2022; 83:232-236. [PMID: 35489413 DOI: 10.1016/j.ando.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 03/03/2022] [Accepted: 03/10/2022] [Indexed: 11/21/2022]
Abstract
INTRODUCTION After a nondiagnostic (ND) result or findings of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), the current recommendation is for fine-needle aspiration cytology (FNAC) of the thyroid nodule to be repeated after at least 3 months. The aim of this study was to evaluate whether the interval between FNACs has any influence on the final cytological diagnosis. METHODS This was a retrospective study including all patients who underwent FNAC for the first time between January 2016 and December 2019 with ND or AUS/FLUS cytological results and then underwent a second FNAC procedure. Demographic, clinical, ultrasound and cytological data were retrieved. 1,497 nodules were evaluated; 535 had a first FNAC result of ND or AUS/FLUS, and 246 of these were re-evaluated with a second FNAC. The cases were grouped according to the timing of the repeat FNAC in two different analyses: < vs. ≥ 3 months and < vs. ≥ 6 months after initial FNAC. RESULTS Two hundred forty-six repeat FNACs were performed in 186 patients (76% female, median age 59.5 years). Twenty-two of these procedures (8.9%) were performed within 3 months, and 115 (46.2%) within 6 months of the first FNAC. Second FNAC findings were ND in 121 (49.2%) cases, benign in 103 (41.9%), AUS/FLUS in 8 (3.3%), follicular neoplasm/suspicious follicular neoplasm in 9 (3.7%), suspicious malignancy in 4 (1.6%) and malignancy in 1 (0.4%). Early repetition of FNAC did not significantly influence the final cytological result (< 3 vs. ≥ 3 months, P=0.51; and < 6 vs. ≥ 6 months, P=0.20). CONCLUSION This study suggests that the interval in repeat FNAC procedures is not relevant to overall diagnostic performance.
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Doubi A, Alrayes NS, Alqubaisi AK, Al-Dhahri SF. The value of repeating fine-needle aspiration for thyroid nodules. Ann Saudi Med 2021; 41:36-42. [PMID: 33550907 PMCID: PMC7868617 DOI: 10.5144/0256-4947.2021.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Fine-needle aspiration (FNA) is an invaluable technique used in the evaluation of thyroid nodules. OBJECTIVES Evaluate the concordance of results for consecutive FNA readings. DESIGN Retrospective, descriptive. SETTINGS Two tertiary care centers. METHODS Demographics were collected along with every FNA result and final pathology results for all patients (aged 9-90 years old) who underwent thyroid surgery from 2010 to 2017. The Bethesda system was used for cytology. Agreement levels were calculated and compared with final pathology. SAMPLE SIZE Of 1237 initially included, 1134 had at least one FNA performed with results available for review. RESULTS For the 1134 patients, demographic and clinical data were collection and a comparison was made between the three FNA results; the highest agreement was between FNA 2 and 3 (53.6%); however, the kappa value was consistently low for all comparisons, indicating a poor level of agreement overall. Also, the risk of malignancy was higher in this study than in the 2017 Bethesda system for reporting thyroid cytopathology in FNA cytology categories I and II. CONCLUSION Repeating FNA biopsies yield different results every time; hence, there is a low level of agreement. The clinical decision should therefore include other important risk factors. Prospective studies could help shed more light on this topic. LIMITATIONS Retrospective design. CONFLICT OF INTEREST None.
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Affiliation(s)
- Aseel Doubi
- From the Department of Otolaryngology Head and Neck Surgery, King Saud University, Riyadh, Saudi Arabia
| | - Nuha S Alrayes
- From the Department of Otolaryngology Head and Neck Surgery, Dr. Sulaiman AlHabib Medical Center, Riyadh, Saudi Arabia
| | - Abdulaziz K Alqubaisi
- From the Department of Medical Imaging, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Saleh F Al-Dhahri
- From the Department of Otolaryngology Head and Neck Surgery, King Saud University, Riyadh, Saudi Arabia
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San Laureano FC, Alba JJF, Heras JMJ, Millán AIJ, Fernández-Ladreda MT, Ortega MDCA. Development and Internal Validation of a Predictive Model for Individual Cancer Risk Assessment for Thyroid Nodules. Endocr Pract 2020; 26:1077-1084. [PMID: 33471709 DOI: 10.4158/ep-2020-0004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 05/10/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The objective of this study was to develop and validate a predictive model for the assessment of the individual risk of malignancy of thyroid nodules based on clinical, ultrasound, and analytic variables. METHODS A retrospective case-control study was carried out with 542 patients whose thyroid nodules were analyzed at our endocrinology department between 2013 and 2018 while undergoing treatment for thyroidectomy. Starting with a multivariate logistic regression analysis, which included clinical, analytic, and ultrasound variables, a predictive model for thyroid cancer (TC) risk was devised. This was then subjected to a cross-validation process, using resampling techniques. RESULTS In the final model, the independent predictors of the risk of malignancy were: being male, age of the extremes, family history of TC, thyroid-stimulating hormone level >4.7 μU/L, presence of autoimmune thyroiditis, solid consistency, hypoechogenicity, irregular or microlobed borders, nodules that are taller than they are wide, microcalcifications, and suspicious adenopathy. With a cut-off point of 50% probability of thyroid cancer, the predictive model had an area under the receiver operating characteristic curve of 0.925 (95% confidence interval 0.898 to 0.952). Finally, using the 10-fold cross-validation method, the accuracy of the model was found to be 88.46%, with a kappa correlation coefficient of 0.62. CONCLUSION A predictive model for the individual risk of malignancy of thyroid nodules was developed and validated using clinical, analytic, and ultrasound variables. An online calculator was developed from this model to be used by clinicians to improve decision-making in patients with thyroid nodules.
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The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Thyroid Disease in Adults. Ann Surg 2020; 271:e21-e93. [PMID: 32079830 DOI: 10.1097/sla.0000000000003580] [Citation(s) in RCA: 238] [Impact Index Per Article: 59.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To develop evidence-based recommendations for safe, effective, and appropriate thyroidectomy. BACKGROUND Surgical management of thyroid disease has evolved considerably over several decades leading to variability in rendered care. Over 100,000 thyroid operations are performed annually in the US. METHODS The medical literature from 1/1/1985 to 11/9/2018 was reviewed by a panel of 19 experts in thyroid disorders representing multiple disciplines. The authors used the best available evidence to construct surgical management recommendations. Levels of evidence were determined using the American College of Physicians grading system, and management recommendations were discussed to consensus. Members of the American Association of Endocrine Surgeons reviewed and commented on preliminary drafts of the content. RESULTS These clinical guidelines analyze the indications for thyroidectomy as well as its definitions, technique, morbidity, and outcomes. Specific topics include Pathogenesis and Epidemiology, Initial Evaluation, Imaging, Fine Needle Aspiration Biopsy Diagnosis, Molecular Testing, Indications, Extent and Outcomes of Surgery, Preoperative Care, Initial Thyroidectomy, Perioperative Tissue Diagnosis, Nodal Dissection, Concurrent Parathyroidectomy, Hyperthyroid Conditions, Goiter, Adjuncts and Approaches to Thyroidectomy, Laryngology, Familial Thyroid Cancer, Postoperative Care and Complications, Cancer Management, and Reoperation. CONCLUSIONS Evidence-based guidelines were created to assist clinicians in the optimal surgical management of thyroid disease.
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Chung SR, Baek JH, Choi YJ, Sung TY, Song DE, Kim TY, Lee JH. The Role of Core Needle Biopsy for the Evaluation of Thyroid Nodules with Suspicious Ultrasound Features. Korean J Radiol 2018; 20:158-165. [PMID: 30627031 PMCID: PMC6315075 DOI: 10.3348/kjr.2018.0101] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 04/03/2018] [Indexed: 01/21/2023] Open
Abstract
Objective Recent studies demonstrated that core needle biopsy (CNB) can effectively reduce the possibility of inconclusive results and prevent unnecessary diagnostic surgery. However, the effectiveness of CNB in patients with suspicious thyroid nodules has not been fully evaluated. This prospective study aimed to determine the potential of CNB to assess thyroid nodules with suspicious ultrasound (US) features. Materials and Methods Patients undergoing CNB for thyroid nodules with suspicious features on US were enrolled between May and August 2016. Diagnostic performance and the incidence of non-diagnostic results, inconclusive results, conclusive results, malignancy, unnecessary surgery, and complications were analyzed. Subgroup analysis according to nodule size was performed. The risk factors associated with inconclusive results were evaluated using multivariate logistic regression analysis. Results A total of 93 patients (102 thyroid nodules) were evaluated. All samples obtained from CNB were adequate for diagnosis. Inconclusive results were seen in 12.7% of cases. The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for diagnosis of malignancy were 93.8%, 100%, 100%, 78.9%, and 95%, respectively. None of the patients underwent unnecessary surgery. The diagnostic performance was not significantly different according to nodule size. On multivariate logistic regression analysis, larger nodule size and shorter needle length were independent risk factors associated with inconclusive results. Conclusion Samples obtained by CNB were sufficient for diagnosis in all cases and resulted in high diagnostic values and conclusive results in the evaluation of suspicious thyroid nodules. These findings indicated that CNB is a promising diagnostic tool for suspicious thyroid nodules.
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Affiliation(s)
- Sae Rom Chung
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jung Hwan Baek
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Young Jun Choi
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Tae-Yon Sung
- Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Dong Eun Song
- Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Tae Yong Kim
- Department of Endocrinology and Metabolism, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jeong Hyun Lee
- Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Yordanova A, Mahjoob S, Lingohr P, Kalff J, Türler A, Palmedo H, Biersack HJ, Kristiansen G, Farahati J, Essler M, Ahmadzadehfar H. Diagnostic accuracy of [ 99mTc]Tc-Sestamibi in the assessment of thyroid nodules. Oncotarget 2017; 8:94681-94691. [PMID: 29212258 PMCID: PMC5706904 DOI: 10.18632/oncotarget.21866] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/16/2017] [Indexed: 11/25/2022] Open
Abstract
[99mTc]Tc-Sestamibi (MIBI) is an increasingly used tool for evaluation of thyroid nodules. However, there is a lack of evidence about the accuracy of this method in the European population. The aim of this study was to assess the utility of MIBI for the differentiation of thyroid nodules in a large cohort. 161 patients underwent MIBI, followed by a thyroidectomy. We used a dual phase MIBI protocol. Interpretation of the images included a scoring system from 0 (absent) to 3 (increased); this was to provide a scale for the uptake of the thyroid nodule in comparison to the paranodular tissue. Additionally, we evaluated the tracer uptake trend in late images compared to early images. We used the final histopathology as the reference standard. Scores 0-1 in early images, scores 0-2 in late images, and an absence of increasing uptake in the thyroid nodule in late images, showed the best predictive values to exclude malignancy, respectively (negative predictive value (NPV) 89%). Highest sensitivity (91%) for malignant nodules was evident in early images with a score 1-3. Highest specificity (91%) was obtained when the negative was defined as an absence of uptake-increase, in the late images. This study confirms that the most valuable feature of MIBI is the high NPV. Thus, with the appropriate interpretation method, high sensitivity and specificity, and moderate PPV can be obtained.
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Affiliation(s)
- Anna Yordanova
- Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany
| | - Soha Mahjoob
- Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany
| | - Philipp Lingohr
- Department of Surgery, University Hospital Bonn, Bonn, Germany
| | - Jörg Kalff
- Department of Surgery, University Hospital Bonn, Bonn, Germany
| | - Andreas Türler
- Department of General and Visceral Surgery, Johanniter-Krankenhaus Bonn, Bonn, Germany
| | - Holger Palmedo
- Institute of Radiology and Nuclear Medicine, PET-CT Center, Bonn, Germany
| | | | | | - Jamshid Farahati
- Department of Nuclear Medicine, Bethesda Hospital, Duisburg, Germany
| | - Markus Essler
- Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany
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Repeated nondiagnostic result of thyroid fine-needle aspiration biopsy. Contemp Oncol (Pozn) 2017; 20:491-495. [PMID: 28239289 PMCID: PMC5320464 DOI: 10.5114/wo.2016.65611] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 11/26/2016] [Indexed: 01/21/2023] Open
Abstract
Aim of the study Fine-needle aspiration biopsy (FNAB) is the most accurate and cost-effective method to evaluate the risk of malignancy of thyroid nodules, but approximately 1–24% of FNABs generate a nondiagnostic result (ND-FNAB). The aim of this study was to determine the predictive factors of a repeated nondiagnostic result of FNAB. Material and methods A total of 4018 FNABs performed in a territorial referral centre were analysed, of which 288 (7.17%) were nondiagnostic. Medical records were available for 245 biopsies performed in 228 patients. The retrospective analysis of factors that may influence a repeat ND-FNAB, including demographic, clinical and ultrasound characteristics, was performed. Results A repeat FNAB was performed in 159 nodules giving a diagnostic result in 79.2% of cases. The time between the biopsies ranged from 1 to 611 days (mean 154.4, median 119). The timing of a repeat FNAB did not significantly alter the diagnostic output (p = 0.29). In the univariate analysis, significant predictors of a repeat ND-FNAB were older patient age (p = 0.02), L-thyroxine supplementation (p = 0.05), and a history of 131I therapy (p < 0.0001). In the multivariate analysis, only a history of 131I therapy was a statistically significant risk factor for a repeat ND-FNAB (p = 0.002). Conclusions Patients with a history of 131I therapy and ND-FNAB should undergo periodic ultrasonographic assessment rather than a repeat biopsy. The interval between repeated FNABs recommended by guidelines does not affect the diagnostic output.
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A Different Perspective on Evaluating the Malignancy Rate of the Non-Diagnostic Category of the Bethesda System for Reporting Thyroid Cytopathology: A Single Institute Experience and Review of the Literature. PLoS One 2016; 11:e0162745. [PMID: 27627674 PMCID: PMC5023124 DOI: 10.1371/journal.pone.0162745] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 08/26/2016] [Indexed: 01/21/2023] Open
Abstract
Objective To determine the malignancy rate in the non-diagnostic (ND) category of the Bethesda System for Reporting Thyroid Cytopathology (BSRTC) based on a different approach in relation to histopathology diagnoses. Study Design All ND fine needle aspirations (FNAs) that were performed under ultrasound guidance by an interventional radiologist with rapid on-site evaluation were included in the study. Slides were reevaluated to identify the cause of inadequacy as “qualitative” or “quantitative.” The malignancy rate of the ND category was assessed. Nodule/patient characteristics were compared between benign and malignant cases within the study cohort. Results The study cohort consisted of 192 ND aspirations. Overall there were 156 (81.3%) women and 36 (18.7%) men with a mean age of 50.6 years (range 24–82 years). The malignancy rate was 4.7%. None of the nodules (size, consistency, and number) or patient characteristics (gender and age) were found to be predictive of malignancy. Conclusion The malignancy rate of the ND category was high when compared to BSRTC predictions, but at the low end of the reported malignancy rates in the literature. Our results revealed that cyto-histopathologic correlation and method of malignancy rate estimation could have an effect on a wide range of reported malignancy rates. Furthermore, patient/nodule dependent factors were not statistically found to be predictive of malignancy.
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Kim KH, Woo SH. An Occupational Study in Nurses: Prevalence of Thyroid Nodules and Cancer in Comparison to Health Check-up Female. Clin Exp Otorhinolaryngol 2016; 9:252-6. [PMID: 27334518 PMCID: PMC4996109 DOI: 10.21053/ceo.2015.01109] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 07/30/2015] [Accepted: 09/02/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES It is known that a great extent of radiation is emitted from the medical instruments used in hospitals and that radiation exposure can cause thyroid cancer. However, the correlation between occupational radiation exposure in hospitals and thyroid disease is not extensively recognized. METHODS The subjects of the study were female nurses, who worked at a single hospital and female, who had undergone a health examination at the same hospital during the same period. The 1,024 nurses and 2,631 healthy women were enrolled for the present study. All the participants were screened using thyroid ultrasonography, and fine-needle aspiration & cytology was performed on potentially malignant nodules. RESULTS Thyroid nodules were present in 315 nurses (30.8%) and 1,023 health check-up female (38.9%). Typically, 107 nurses (10.4%) and 201 health check-up female (7.6%) had suspicious nodule and were further tested with ultrasonography guided fine-needle aspiration & cytology. The 16 nurses (1.6%) and 38 health check-up female (1.4%) were diagnosed with thyroid cancer. The prevalence of thyroid nodules was enhanced in both the groups and a significant increase was noted in health check-up female group (P<0.05); however, no difference was seen in the incidence of thyroid cancer in both the groups (P>0.05). CONCLUSION In our study, working in a hospital does not increase the prevalence of thyroid nodules or thyroid cancer.
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Affiliation(s)
- Kyung Hee Kim
- Department of Otolaryngology, Gyeongsang National University, Jinju, Korea.,Department of Nursing, Graduate School, Gyeongsang National University, Jinju, Korea
| | - Seung Hoon Woo
- Department of Otolaryngology, Gyeongsang National University, Jinju, Korea.,Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
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Starker LF, Prieto PA, Liles JS, Tran Cao HS, Grubbs EG, Lee JE, Perrier ND, Graham PH. Endocrine incidentalomas. Curr Probl Surg 2016; 53:219-46. [DOI: 10.1067/j.cpsurg.2016.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 04/22/2016] [Indexed: 12/21/2022]
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Eun NL, Yoo MR, Gweon HM, Park AY, Kim JA, Youk JH, Moon HJ, Chang HS, Son EJ. Thyroid nodules with nondiagnostic results on repeat fine-needle aspiration biopsy: which nodules should be considered for repeat biopsy or surgery rather than follow-up? Ultrasonography 2016; 35:234-43. [PMID: 27068131 PMCID: PMC4939721 DOI: 10.14366/usg.15079] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2015] [Revised: 02/29/2016] [Accepted: 03/06/2016] [Indexed: 01/09/2023] Open
Abstract
Purpose: The goal of this study was to assess the clinicopathologic and ultrasonographic features of thyroid nodules with nondiagnostic results on repeat ultrasonography (US)-guided fineneedle aspiration biopsy (FNAB) according to size and the number of suspicious findings and to determine the proper management of nodules with consecutive nondiagnostic results. Methods: This retrospective study included 297 nodules with nondiagnostic results on repeat FNAB that were evaluated by US over the course of at least 12 months of follow-up, a follow-up biopsy, or an operation. We compared clinical and US variables between benign and malignant nodules in thyroid nodules with repeat nondiagnostic results. Results: The comparison of benign and malignant nodules with repeat nondiagnostic results revealed that age, marked hypoechogenicity, irregular or microlobulated margins, microcalcifications, and nonparallel shape were significantly associated with malignancy. Multivariate logistic regression analysis in malignant nodules revealed that microcalcifications and irregular or microlobulated margins were independently associated with malignancy. Among them, only irregular or microlobulated margins were independently significant as a predictor of malignancy in repeatedly nondiagnostic nodules measuring >10 mm. Using receiver operating characteristic analysis, the best cutoff value for the “number of suspicious findings” between benign and malignant nodules was three in nodules of all sizes, three in nodules measuring ≤10 mm, and two in nodules measuring >10 mm. Conclusion: Irregular or microlobulated margins may be the most frequent US features in repeatedly nondiagnostic nodules >10 mm. The presence of “two or more suspicious findings” can be used as the cutoff for distinguishing benign and malignant nodules.
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Affiliation(s)
- Na Lae Eun
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Mi Ri Yoo
- Department of Radiology, Dongjak Kyunghee Hospital, Seoul, Korea
| | - Hye Mi Gweon
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ah Young Park
- Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Jeong-Ah Kim
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Hyun Youk
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hee Jung Moon
- Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hang-Seok Chang
- Department of Surgery, Thyroid Cancer Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Ju Son
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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