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Diagnostic Thyroidectomy May Be Preferable in Patients With Suspicious Ultrasonography Features After Cytopathology Diagnosis of AUS/FLUS in the Bethesda System

Authors
 Yong Sang Lee  ;  Hyeung Kyoo Kim  ;  Hojin Chang  ;  Seok Mo Kim  ;  Bup-Woo Kim  ;  Hang-Seok Chang  ;  Cheong Soo Park 
Citation
 MEDICINE, Vol.94(51) : e2183, 2015 
Journal Title
 MEDICINE 
ISSN
 0025-7974 
Issue Date
2015
MeSH
Biopsy, Fine-Needle ; Calcinosis ; Humans ; Retrospective Studies ; Thyroid Neoplasms/diagnosis* ; Thyroid Neoplasms/diagnostic imaging ; Thyroid Neoplasms/pathology* ; Thyroid Nodule/diagnostic imaging ; Thyroid Nodule/pathology* ; Thyroidectomy/methods* ; Ultrasonography, Interventional
Abstract
Atypia/follicular lesion of undetermined significance (AUS/FLUS) is a new category in the Bethesda System for Reporting Thyroid Cytopathology (BSRTC) for which repeat fine-needle aspiration cytology (FNAC) is recommended. The aim of this study was to identify specific ultrasonography and clinical predictors of malignancy in a subset of thyroid nodules associated with cytology diagnoses of AUS/FLUS.Between January 2011 and December 2102, 5440 patients underwent thyroid surgery at our institution. Of these, 213 patients were diagnosed AUS/FLUS at the preoperative cytopathology diagnosis. The frequency of FNAC and ultrasonography images was compared between patients with cancerous and benign tumors based on their final pathology.Of the 213 patients, 158 (74.2%) were diagnosed with thyroid carcinoma in their final pathology reports. In univariate and multivariate analyses, the frequency of FNAC was not significantly correlated with the cancer diagnosis. Hypoechogenicity (odds ratio 2.521, P = 0.007) and microcalcification (odds ratio 3.247, P = 0.005) were statistically correlated with cancer risk.Although AUS/FLUS in cytopathology is recommended for repeating FNAC in BSRTC, we proposed that thyroid nodules with ultrasonography findings that suggest the possibility of cancer should undergo thyroidectomy with diagnostic intent.
Files in This Item:
T201505019.pdf Download
DOI
10.1097/MD.0000000000002183
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Bup Woo(김법우) ORCID logo https://orcid.org/0000-0002-1342-9055
Kim, Seok Mo(김석모) ORCID logo https://orcid.org/0000-0001-8070-0573
Kim, Hyung Kyu(김형규)
Park, Cheong Soo(박정수)
Lee, Yong Sang(이용상) ORCID logo https://orcid.org/0000-0002-8234-8718
Chang, Hang Seok(장항석) ORCID logo https://orcid.org/0000-0002-5162-103X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/156999
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