Clinical and Ultrasound Thyroid Nodule Characteristics and Their Association with Cytological and Histopathological Outcomes: A Retrospective Multicenter Study in High-Resolution Thyroid Nodule Clinics.

Autor: Molina-Vega M; Department of Endocrinology and Nutrition, Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain., Rodríguez-Pérez CA; Department of Endocrinology, Insular University Hospital of Gran Canaria, 35016 Las Palmas de Gran Canaria, Spain., Álvarez-Mancha AI; Department of Pathology, Virgen de la Victoria University Hospital, 29010 Málaga, Spain., Baena-Nieto G; Department of Endocrinology, Jerez Hospital, 11408 Jerez de la Frontera, Cádiz, Spain., Riestra M; Department of Endocrinology, University Hospital of Cabueñes, 33394 Gijón, Spain., Alcázar V; Department of Endocrinology, Hospital Severo Ochoa, 28911 Leganés, Madrid, Spain., Romero-Lluch AR; Department of Endocrinology, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain., Galofré JC; Department of Endocrinology, Clínica Universidad de Navarra, 31008 Pamplona, Spain., Fernández-García JC; Department of Endocrinology and Nutrition, Instituto de Investigación Biomédica de Málaga (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2019 Dec 09; Vol. 8 (12). Date of Electronic Publication: 2019 Dec 09.
DOI: 10.3390/jcm8122172
Abstrakt: Introduction: Thyroid nodules are a common finding. A high-resolution thyroid nodule clinic (HR-TNC) condenses all tests required for the evaluation of thyroid nodules into a single appointment. We aimed to evaluate the clinical outcomes at HR-TNCs.
Design and Methods: A retrospective cross-sectional multicenter study including data from four HR-TNCs in Spain. We evaluated fine-needle aspiration (FNA) indications and the association between clinical and ultrasound characteristics with cytological and histopathological outcomes.
Results: A total of 2809 thyroid nodules were included; FNA was performed in 82.1%. Thyroid nodules that underwent FNA were more likely larger, isoechoic, with microcalcifications, and in younger subjects. The rate of nondiagnostic FNA was 4.3%. A solid component, irregular margins or microcalcifications, significantly increased the odds of Bethesda IV-V-VI (vs. Bethesda II). Irregular margins and a solid component were independently associated with increased odds of malignancy. Thyroid nodules <20 mm and ≥20-<40 mm had a 6.5-fold and 3.3-fold increased risk for malignancy respectively in comparison with those ≥40 mm.
Conclusion: In this large multicenter study, we found that the presence of a solid component and irregular margins are factors independently related to malignancy in thyroid nodules. Since nodule size ≥40 mm was associated with the lowest odds of malignancy, this cut-off should not be a factor leading to indicate thyroid surgery. HR-TNCs were associated with a low rate of nondiagnostic FNA.
Databáze: MEDLINE
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