Risk factors associated with malignancy and with triage to surgery in thyroid nodules classified as Bethesda category III (AUS/FLUS)

被引:40
|
作者
Kuru, B. [1 ]
Atmaca, A. [2 ]
Tarim, I. A. [3 ]
Kefeli, M. [4 ]
Topgul, K. [5 ]
Yoruker, S. [1 ]
Elmali, M. [6 ]
Danaci, M. [6 ]
机构
[1] Ondokuz Mayis Univ, Dept Gen Surg, Sch Med, Samsun, Turkey
[2] Ondokuz Mayis Univ, Dept Internal Med, Sch Med, Div Endocrinol & Metab, Samsun, Turkey
[3] Varto State Hosp, Dept Gen Surg, Varto Mus, Turkey
[4] Ondokuz Mayis Univ, Dept Pathol, Sch Med, Samsun, Turkey
[5] Kemerburgaz Univ, Sch Med, Dept Gen Surg, Istanbul, Turkey
[6] Ondokuz Mayis Univ, Dept Radiol, Sch Med, Samsun, Turkey
来源
EJSO | 2016年 / 42卷 / 01期
关键词
Bethesda III category; Atypia of undetermined significance; Predictive factors for thyroid malignancy; Factors to triage to thyroid surgery; Selection of nodules for thyroid surgery; FINE-NEEDLE-ASPIRATION; UNDETERMINED SIGNIFICANCE; FOLLICULAR LESIONS; ATYPIA; DIAGNOSIS; CYTOLOGY; MANAGEMENT; ULTRASONOGRAPHY; SYSTEM; STATE;
D O I
10.1016/j.ejso.2015.09.026
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Selection of nodules for surgery diagnosed as Bethesda category III [atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) category] is very important. We aimed at to define the predictive factors for malignancy and factors, associated with triage to surgery. Methods: The records of all patients with nodules who underwent fine needle aspiration biopsy (FNAB) and classified by Bethesda reporting system as AUS/FLUS between 2011 and 2015 at our institution were reviewed. Univariate and multivariate analysis were performed to select independent factors associated with thyroid cancer and with triage to surgery. Using independent risk factors for malignancy predictive index categories were created. Results: Of the 485 patients who were classified as AUS/FLUS on initial FNAB, 153 underwent surgery with the associated malignancy rate of 22.8%. The malignancy rates for AUS/FLUS patients with and without repeat FNAB were 37.5% and 16.2%, respectively. Multivariate logistic regression analysis revealed that solid structure, microcalcification, hypoechogenicity, increased vascularization, and irregular margin were found to be significant and independent risk factors associated for malignancy, and solid structure, microcalcifications, increased nodule size (>= 2 cm) and younger patient age (<65 years) were associated with triage to surgery. Conclusions: Our findings showed that using predictive factors for malignancy in AUS/FLUS category as risk indices, an important proportion of patients (35%) who had nodules without any risk factors could be spared unnecessary surgery. We suggest that predictive indices should be considered for selection of the patients to triage to surgery. (C) 2015 Elsevier Ltd. All rights reserved.
引用
收藏
页码:87 / 93
页数:7
相关论文
共 50 条
  • [1] Malignancy Rate in Thyroid Nodules Classified as Bethesda Category III (AUS/FLUS)
    Ho, Allen S.
    Sarti, Evan E.
    Jain, Kunal S.
    Wang, Hangjun
    Nixon, Iain J.
    Shaha, Ashok R.
    Shah, Jatin P.
    Kraus, Dennis H.
    Ghossein, Ronald
    Fish, Stephanie A.
    Wong, Richard J.
    Lin, Oscar
    Morris, Luc G. T.
    [J]. THYROID, 2014, 24 (05) : 832 - 839
  • [2] Malignancy Rate in Thyroid Nodules Classified as Bethesda Category III (AUS/FLUS): Is There a Correct Answer?
    Heller, Keith S.
    [J]. THYROID, 2014, 24 (05) : 787 - 788
  • [3] Risk factors associated with malignancy and with triage to surgery in thyroid nodules classified as Bethesda category IV (FN/SFN)
    Kuru, Bekir
    Kefeli, Mehmet
    [J]. DIAGNOSTIC CYTOPATHOLOGY, 2018, 46 (06) : 489 - 494
  • [4] The Prediction of Malignancy Risk in Thyroid Nodules Classified as Bethesda System Category III (AUS/FLUS) and the Role of Ultrasound Finding for Prediction of Malignancy Risk
    Alshahrani, Awad S.
    Alamri, Abdulrahman S.
    Balkhoyor, Abdulrahman H.
    Mahzari, Moeber M.
    Alshieban, Saeed S.
    Majed, Pharaon M.
    [J]. CUREUS JOURNAL OF MEDICAL SCIENCE, 2021, 13 (09)
  • [5] Patient outcomes following surgical management of thyroid nodules classified as Bethesda category III (AUS/FLUS)
    Mulita, Francesk
    Plachouri, Maria-Kerasia
    Liolis, Elias
    Vailas, Michail
    Panagopoulos, Konstantinos
    Maroulis, Ioannis
    [J]. ENDOKRYNOLOGIA POLSKA, 2021, 72 (02) : 143 - 144
  • [6] WHICH FACTORS ARE ASSOCIATED WITH MALIGNANCY IN THYROID NODULES CLASSIFIED AS BETHESDA CATEGORY 3 (AUS/FLUS) AND HOW DO THEY INFLUENCE THE PATIENT'S MANAGEMENT?
    Kaya, C.
    Bozkurt, E.
    Mut, D. Turkyilmaz
    Mihmanli, M.
    Uludag, M.
    [J]. ACTA ENDOCRINOLOGICA-BUCHAREST, 2019, 15 (04) : 491 - 496
  • [7] Predictors of Malignancy in Thyroid Nodules Classified as Bethesda Category III
    Liu, Xiaoli
    Wang, Jingjing
    Du, Wei
    Dai, Liyuan
    Fang, Qigen
    [J]. FRONTIERS IN ENDOCRINOLOGY, 2022, 13
  • [8] Thyroid cancer detection rate and associated risk factors in patients with thyroid nodules classified as Bethesda category III
    Mileva, Magdalena
    Stoilovska, Bojana
    Jovanovska, Anamarija
    Ugrinska, Ana
    Petrushevska, Gordana
    Kostadinova-Kunovska, Slavica
    Miladinova, Daniela
    Majstorov, Venjamin
    [J]. RADIOLOGY AND ONCOLOGY, 2018, 52 (04) : 370 - 376
  • [9] Evaluation of Risk Factors for Malignancy Obtained by Means of Fine Needle Aspiration Biopsies in Thyroid Nodules and Surgical Outcomes of Patients with Bethesda Category III (AUS/FLUS)
    Kimiloglu, Elife
    Ozdemir, Muhammed
    Cobanoglu, Pelin
    Kavuncu, Beyza
    Gonullu, Dogan
    [J]. CHIRURGIA, 2023, 118 (02) : 137 - 145
  • [10] Evidence for overestimation of the prevalence of malignancy in indeterminate thyroid nodules classified as Bethesda category III
    Iskandar, Mazen E.
    Bonomo, Giovanni
    Avadhani, Vaidehi
    Persky, Mark
    Lucido, David
    Wang, Beverly
    Marti, Jennifer L.
    [J]. SURGERY, 2015, 157 (03) : 510 - 517