Retrospective cytological evaluation of indeterminate thyroid nodules according to the British Thyroid Association 2014 classification and comparison of clinical evaluation and outcomes

Autor: Massimo Giusti, Barbara Massa, Margherita Balestra, Paola Calamaro, Stefano Gay, Simone Schiaffino, Giovanni Turtulici, Simonetta Zupo, Eleonora Monti, Gianluca Ansaldo
Rok vydání: 2017
Předmět:
Male
Pathology
Databases
Factual
DNA Mutational Analysis
Thyroid Function Tests
0302 clinical medicine
Cytology
80 and over
Thyroid Nodule
General Pharmacology
Toxicology and Pharmaceutics
Outcome
Ultrasonography
Aged
80 and over
medicine.diagnostic_test
Incidence (epidemiology)
Thyroid
Doppler
General Medicine
Middle Aged
Indeterminate thyroid nodules
medicine.anatomical_structure
Treatment Outcome
030220 oncology & carcinogenesis
Elasticity Imaging Techniques
Female
Indeterminate
Thyroid nodules
Adult
Risk
medicine.medical_specialty
Adolescent
Cytological Techniques
British Thyroid Association 2014 classification
Clinical evaluation
Aged
Humans
Mutation
ROC Curve
Retrospective Studies
Thyroid Diseases
Thyroid Neoplasms
Ultrasonography
Doppler
Young Adult
030209 endocrinology & metabolism
Malignancy
Thyroid function tests
General Biochemistry
Genetics and Molecular Biology
Article
Databases
03 medical and health sciences
medicine
Factual
General Veterinary
business.industry
Histology
medicine.disease
business
Zdroj: Journal of Zhejiang University. Science. B. 18(7)
ISSN: 1862-1783
Popis: The cytology of 130 indeterminate nodules (Thy 3) was retrospectively reviewed according to the British Thyroid Association 2014 classification. Nodules were divided into Thy 3a (atypical features) and Thy 3f (follicular lesion) categories. Histology was available as a reference for 97 nodules. Pre-surgical evaluations comprised biochemical tests, color-Doppler ultrasonography (US), semi-quantitative elastography-US (USE), contrast-enhanced US (CEUS), and mutation analysis from cytological slides. Thyroid malignancy was the final diagnosis for 19% of surgically-treated nodules. No statistically significant difference in the risk of malignancy was found between Thy 3a (26%) and Thy 3f (14%) nodules. Histology of the Thy 3a and Thy 3f nodules showed a higher incidence of Hurtle cell adenomas in Thy 3f (29%) than in Thy 3a (3%) nodules (P=0.01). The only pre-surgical difference concerned the BRAF V600E mutation, which was positive in some Thy 3a but not in any Thy 3f nodules (P=0.04). Receiver-operating characteristic (ROC) analysis was used to obtain cut-off values from US (score), USE (ELX 2/1 strain index), and CEUS (time-to-peak index and peak index) data. The cut-off values were similar for Thy 3a and Thy 3f nodules. Data showed that malignancy can be suspected if the US score is >2, ELX 1/2 strain index >1, time-to-peak index >1, and peak index
Databáze: OpenAIRE
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