A Standardized Assessment of Thyroid Nodules in Children Confirms Higher Cancer Prevalence Than in Adults

Gupta, Anjuli M.; Ly, Sophia; Castroneves, Luciana A.; Frates, Mary C.; Benson, Carol B.; Feldman, Henry A.; Wassner, Ari J.; Smith, Jessica R.; Marqusee, Ellen; Alexander, Erik K.; Barletta, Justine A.; Doubilet, Peter M.; Peters, Hope E.; Webb, Susan M.; Modi, Biren P.; Paltiel, Harriet J.; Kozakewich, Harry; Cibas, Edmund S.; Moore, Francis D.; Shamberger, Robert C.; Larsen, P. Reed; Huang, Stephen A.

doi:10.1210/jc.2013-1796

Cited by 227 publications

(242 citation statements)

References 33 publications

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“…One limitation of the present study is that the ND rate in solid nodules was 26.77% higher compared to the results from Brigham and Women's Hospital (BWH) and Boston Children's Hospital, which was ~13% (21,24,38). One of the important factors lies in the different sample preservation techniques.…”

Section: Discussionmentioning

confidence: 64%

Comparison of two different standards of care in detecting malignant thyroid nodules using thyroid fine-needle aspiration

Liu

Zhu

Wang

et al. 2015

Molecular and Clinical Oncology

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Abstract. The aim of the present study was to verify the optimal method to obtain enough fine-needle aspiration (FNA) materials for detecting thyroid malignancy. A prospective study was performed by comparing two different regional standards of care. In one group a traditional FNA method mainly used in Asian countries, including China, was performed in which a single pass of a 22-G needle was applied with or without aspiration. In the other group, the method mainly used in Western countries was performed in which three passes of a 25-G needle with non-aspiration were undertaken for thyroid nodules. The study included 718 thyroid nodules from 695 patients. These nodules were allocated for three different methods of performing thyroid FNA. There were 332 thyroid nodules subjected to the traditional Asian FNA method using a 22-G needle with aspiration for 142 nodules and non-aspiration for 190 nodules. FNA using the Western method was performed with three passes of non-aspiration using 25 G for 386 nodules. All the FNAs were performed with the guidance of ultrasound. The components of the nodules were documented. All the samples were reported using the Bethesda System for Reporting Thyroid Cytopathology. Among the 22 G group, the non-diagnostic rate in the aspiration group was as high as 76.76%, which was significantly higher than 44.21% in the non-aspiration group (P<0.01). For the non-aspiration group, the non-diagnostic rate in the 25 G group was 34.97%, which was significantly lower than 44.21% in the 22 G group. In general, the non-diagnostic rate for the 25-G needle was 34.97%, which was significantly lower than 58.13% in all the 22 G groups. For the solid and mixed nodules, the non-diagnostic rate was lower in the 25-G needle group compared to the 22 G groups with statistical significance. The non-aspiration method using a 25-G needle with multiple passes can result in a higher diagnostic rate for thyroid FNA.

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Section: Discussionmentioning

confidence: 64%

Comparison of two different standards of care in detecting malignant thyroid nodules using thyroid fine-needle aspiration

Liu

Zhu

Wang

et al. 2015

Molecular and Clinical Oncology

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“…Однако узлы, выявляемые у пациентов до 18 лет, в 3, а по некоторым данным и в 5 раз чаще оказываются злокачественными. То есть у детей 20-30% узлов являются злокаче-ственными по сравнению с 5-10% у взрос-лых [7].…”

Section: заболевания щитовидной железыunclassified

Pediatric endocrine surgery development

et al. 2017

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Отделение детской хирургии на базе ФГБУ "Эндокринологический научный центр" функционирует около двух лет. За время работы хирургическое лечение получили более 500 пациентов с различной эндокринной патологией. В статье обсуждаются современные диагностические подходы и выбор хирургической тактики при заболеваниях, входящих в круг интересов нового направления детской хирургии -эндокринной хирургии детского возраста. В рамках дискуссии обсуждаются варианты радикального лечения болезни Грейвса у детей, рассматриваются положительные и отрицательные стороны хирургического лечения и радиойодтерапии. Приводится собственная статистика послеоперационного гипопаратиреоза. Предлагается оптимизация алгоритма действий при выявлении узлового зоба у детей. При первичном гиперпаратиреозе делается акцент на сложностях послеоперационного ведения пациентов, связанных с особенностями детского возраста, определяющими остроту реакции на водно-электролитные нарушения. Отдельно рассмотрены данные литературы по заболеваниям надпочечников у детей, демонстрируются собственные клинические случаи, потребовавшие хирургического вмешательства. Освещаются возможности современной нейрохирургической техники, применяемой в Эндокринологическом научном центре при операциях на гипофизе у детей. Пациентам различных возрастных групп проводится трансназальное транссфеноидальное удаление опухолей хиазмально-селлярной области с применением эндоскопической ассистенции. В статье также приведены данные исследований в области изучения болезней поджелудочной железы и их хирургического лечения. Большое внимание уделяется гендерному разделу эндокринной хирургии детского возраста. Обсуждается тактика при нарушениях формирования пола, опухолях половых желез у детей, заболеваниях молочных желез. В заключение обрисовываются перспективы развития эндокринной хирургии детского возраста. Ключевые слова: эндокринная хирургия, педиатрия, опухоли эндокринной системы.Department of pediatric surgery at the Endocrinology Research Centre has been around for nearly two years. During operation, surgical treatment has received more than 500 patients with various endocrine disorders. The article discusses modern diagnostic approaches and surgical options for diseases included in the new direction of pediatric surgery -endocrine surgery in children. There are discussions about options for radical treatment of Graves disease in children, positive and negative aspects of surgical and radioactive iodine treatment. Is own stats of postoperative hyperparathyroidism. Is proposed to optimize the algorithm of actions in identifying thyroid nodules in children. In primary hyperparathyroidism, the emphasis is on the complexity of the postoperative management of patients related to the feature of children's age in determining the severity of the reactions on the water-electrolyte disorders. Separately reviewed the literature of the adrenal glands diseases in children, demonstrating their own clinical cases which required surgical intervention. The authors describe the possibilities of modern ne...

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“…With the improvement in ultrasound (Phuttharak et al, 2009;Cheng et al, 2013;Wu et al, 2013), thyroid FNA (Cibas et al, 2008) and cytopathology reporting system update (Cibas and Ali, 2009), many patients do not need to undergo thyroidectomy to obtain confirmatory diagnosis of thyroid nodules. According to the recent guideline from American Thyroid Association (ATA) (American Thyroid Association Guidelines Taskforce on Thyroid et al, 2009), thyroid FNA under the guidance of ultrasound is the essential mainstay step when making the diagnosis of thyroid nodules (Frates et al, 2006;Yassa et al, 2007;Cheng et al, 2013;Gupta et al, 2013). However, variation exists from country to country, even different regions within one country (Haymart et al, 2013;Van den Bruel et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Annual Financial Impact of Thyroidectomies for Nodular Thyroid Disease in China

Liu

Zhu²,

Cui³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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A large proportion of patients with thyroid nodules in China undergo thyroidectomy in order to get confirmatory histology diagnosis. The financial impact of this modality remains to be investigated. To evaluate rationality of performing thyroidectomy without a routine FNA preoperatively from the economic perspective, we conducted a retrospective, observational study of all archival thyroidectomies with records of cost per stay (CPS), cost per day (CPD) and length of stay (LOS) from 2008 to 2013 in the First Affiliated Hospital of Nanjing Medical University. We compared all the parameters between cancer and non-cancer thyroidectomies. We recruited 6, 140 thyroidectomies with valid records of CPS, CPD and LOS in this period. The CPS of cancer thyroidectomy was significantly higher than non-cancer thyroidectomy. The percentage of cancer thyroidectomy increased from 26.5% to 41.6%. The percentage of annual cost of cancer thyroidectomies rose from 30.2% to 45.2%. The LOS for cancer and non-cancer thyroidectomy decreased while the CPD increased in the past six years. The estimated national cost in 2012 for all thyroidectomies would be USD 1.86 billion with USD 1.09 billion for non-cancer thyroidectomies. We have witnessed great improvement in the healthcare for patients with thyroid nodules in China. However, given limited healthcare resources, currently thyroid FNA for more precise preoperative diagnosis may help to curb the rapidly increasing demand in healthcare costs in the future for nodular thyroid disease in China.

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A Standardized Assessment of Thyroid Nodules in Children Confirms Higher Cancer Prevalence Than in Adults

Cited by 227 publications

References 33 publications

Comparison of two different standards of care in detecting malignant thyroid nodules using thyroid fine-needle aspiration

Comparison of two different standards of care in detecting malignant thyroid nodules using thyroid fine-needle aspiration

Pediatric endocrine surgery development

Annual Financial Impact of Thyroidectomies for Nodular Thyroid Disease in China

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