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Subcategorization of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS): a study applying Thyroid Imaging Reporting and Data System (TIRADS)

Authors
 Jung Hyun Yoon  ;  Hyeong Ju Kwon  ;  Eun-Kyung Kim  ;  Hee Jung Moon  ;  Jin Young Kwak 
Citation
 Clinical Endocrinology, Vol.85(2) : 275-282, 2016 
Journal Title
 Clinical Endocrinology 
ISSN
 0300-0664 
Issue Date
2016
MeSH
Adenocarcinoma, Follicular/diagnostic imaging ; Adenocarcinoma, Follicular/pathology ; Adult ; Biopsy, Needle ; Cytodiagnosis ; Female ; Humans ; Male ; Middle Aged ; Research Design ; Retrospective Studies ; Thyroid Neoplasms/classification* ; Thyroid Neoplasms/diagnostic imaging ; Thyroid Neoplasms/pathology ; Thyroid Nodule/classification ; Thyroid Nodule/diagnostic imaging ; Thyroid Nodule/pathology*
Abstract
OBJECTIVE: To evaluate the clinical significance and compare the imaging features according to the Thyroid Image Reporting and Data System (TIRADS) between atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) subcategories. DESIGN & PATIENTS: A total of 192 thyroid nodules in 188 patients (mean age: 50·2 ± 11·8 years) that had been initially diagnosed as AUS/FLUS on US-guided fine needle aspiration (US-FNA) were included. One cytopathologist retrospectively reviewed the cytology slides, subcategorizing cytology results into AUS and FLUS. A TIRADS category was assigned to each thyroid nodule according to the number of suspicious US features. Clinical, US features and malignancy rates were compared between the two subcategories. RESULTS: Of the 192 AUS/FLUS lesions, 149 (77·6%) were subcategorized as AUS and 43 (22·4%) as FLUS. Of the 192 AUS/FLUS nodules, 82 (42·7%) were malignant. The malignancy rates between AUS and FLUS subcategories were not significantly different, 45·6% to 32·6%, respectively (P = 0·127). When applying TIRADS, significant differences were seen in TIRADS category between benign and malignant nodules in the AUS subcategory (P < 0·001), but not in the FLUS subcategory (P = 0·414). The malignancy rates in TIRADS categories 3, 4a, 4b, 4c and 5 were 15·4%, 22·2%, 33·3%, 57·1% and 80·0% (P < 0·001) in AUS nodules and 40·0%, 50·0%, 23·5%, 22·2% and 0·0% (P = 0·414) in FLUS nodules, respectively. CONCLUSION: Suspicious US features are useful in predicting malignancy among AUS subcategories but not in FLUS subcategories. Subcategorization into AUS and FLUS cytology may be helpful in deciding upon treatment or management of thyroid nodules.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/cen.12987/abstract
DOI
10.1111/cen.12987
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
곽진영(Kwak, Jin Young) ORCID logo https://orcid.org/0000-0002-6212-1495
김은경(Kim, Eun-Kyung) ORCID logo https://orcid.org/0000-0002-3368-5013
문희정(Moon, Hee Jung) ORCID logo https://orcid.org/0000-0002-5643-5885
윤정현(Yoon, Jung Hyun) ORCID logo https://orcid.org/0000-0002-2100-3513
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/151653
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