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Thyroid Cancers with Benign-Looking Sonographic Features Have Different Lymph Node Metastatic Risk and Histologic Subtypes According to Nodule Size

Authors
 Dong Yeob Shin  ;  Young Ki Lee  ;  Kwang Joon Kim  ;  Kyeong Hye Park  ;  Sena Hwang  ;  Se Hee Park  ;  Eun Kyung Kim  ;  Hyeong Ju Kwon  ;  Eun Jig Lee 
Citation
 ENDOCRINE PATHOLOGY, Vol.25(4) : 378-384, 2014 
Journal Title
 ENDOCRINE PATHOLOGY 
ISSN
 1046-3976 
Issue Date
2014
MeSH
Adenocarcinoma, Follicular/diagnostic imaging ; Adenocarcinoma, Follicular/pathology* ; Adenocarcinoma, Follicular/surgery ; Adult ; Biopsy, Fine-Needle ; Carcinoma/diagnostic imaging ; Carcinoma/pathology* ; Carcinoma/surgery ; Carcinoma, Papillary ; Female ; Histocytochemistry ; Humans ; Logistic Models ; Lymph Nodes/diagnostic imaging ; Lymph Nodes/pathology* ; Lymphatic Metastasis ; Male ; Middle Aged ; Retrospective Studies ; Thyroid Neoplasms/diagnostic imaging ; Thyroid Neoplasms/pathology* ; Thyroid Neoplasms/surgery ; Thyroid Nodule/diagnostic imaging ; Thyroid Nodule/pathology* ; Thyroid Nodule/surgery ; Ultrasonography
Keywords
Thyroid cancers ; Papillary thyroid carcinoma ; Lymph node metastasis ; Ultrasonography ; Microcarcinoma
Abstract
A decision to perform fine needle aspiration (FNA) on thyroid nodules mainly depends on sonographic features. We investigated if lymph node metastasis (LNM) risk differed by tumor size of thyroid cancers without suspicious sonographic features. Three hundred sixty patients with thyroid cancers with benign looking sonographic features were grouped by nodule size on ultrasonography (US) (≤ or >1 cm). The clinicopathologic parameters were compared between the groups. A multivariate analysis was performed to discover the independent factors predicting the presence of LNM. The nodules greater than 10 mm on US (n = 157) demonstrated a larger tumor size on histology (17.9 ± 14.5 vs. 5.6 ± 2.4 mm, P < 0.001), a lower frequency of classical papillary thyroid carcinoma (PTC) (58.6 vs. 87.2 %, P < 0.001), and a higher frequency of follicular variant PTC and follicular thyroid carcinoma (19.7 and 17.8 % vs. 9.4 and 1.5 %, respectively, P < 0.01). In subgroup analysis of 269 patients with classical PTC, the larger nodule size on US was associated with a higher prevalence of LNM (28.3 vs. 14.7 %, P = 0.007). A multivariate analysis revealed that classical PTC, extrathyroidal extension, and the US nodule size >10 mm were independent predictive factors of LNM after adjusting for age, sex, TSH level, and multifocality. Thyroid cancers larger than 10 mm with benign US features are more likely to be nonclassical PTC than those with smaller diameters. The larger ones also have an increased risk of LNM in classical PTC. These cases require a more aggressive approach to FNA.
Full Text
http://link.springer.com/article/10.1007/s12022-014-9327-6
DOI
10.1007/s12022-014-9327-6
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Hyeong Ju(권형주)
Kim, Kwang Joon(김광준) ORCID logo https://orcid.org/0000-0002-5554-8255
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Park, Se Hee(박세희)
Shin, Dong Yeob(신동엽) ORCID logo https://orcid.org/0000-0003-1048-7978
Lee, Young Ki(이영기)
Lee, Eun Jig(이은직) ORCID logo https://orcid.org/0000-0002-9876-8370
Hwang, Se Na(황세나)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138627
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