Nódulos com diagnóstico de padrão folicular: marcadores biológicos são o futuro?

Cerutti, Janete M.

doi:10.1590/s0004-27302007000500022

Cited by 10 publications

(4 citation statements)

References 63 publications

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“…The differential diagnosis between follicular adenoma and follicular thyroid carcinoma is hindered owing to the cytological similarity of both lesions and the impossibility of verifying vessel and/or capsule invasion through FNA, which are ultimately the criteria for determining malignancy. The use of the terms "follicular lesion" or "follicular standard" is recommended for these nodules, thus the classification "follicular neoplasia" was adopted herein (4) .…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy between fine needle aspiration biopsy (FNA) and pathological examination of the thyroid

Menegassi¹,

Bordin²,

Oliveira³

2013

J. Bras. Patol. Med. Lab.

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Introduction: Despite the fact that the fine needle aspiration biopsy (FNA) is commonly used in the initial evaluation and distinction of benign and malignant lesions of thyroid nodules, it may yield variable results, inasmuch as it is contingent on the pathologist's analysis and expertise in collecting appropriate samples. Objective: To check the diagnostic accuracy between FNA and pathological examination of thyroid nodules, both performed in a diagnostic pathology service. Methods: Retrospective study carried out in a diagnostic pathology service in Chapecó, Santa Catarina, Brazil. All patients who underwent FNA and pathological examination in the period from January 1 st 2005 to December 31 2010 were included in this study. Results: 1,172 FNA were conducted during this period and 265 patients underwent both FNA and pathological examination. Most patients were female (85%), with mean age 47.75 years (standard deviation [SD] = 14.93 years). Cytopathological examinations yielded the following results: benignity (43.77 %), suspected malignancy (23.77%), follicular neoplasm (5.28%), atypical follicular lesion of undetermined significance (1.51%) and unsatisfactory sample (1.51%). In the pathological examination, the most predominant diagnoses were colloid goiter (38.87%), follicular adenoma (22.64%) and classic papillary carcinoma (18.87%). In satisfactory samples (n = 261), the following results were obtained: diagnostic accuracy (89.66%), sensitivity (82.14%), specificity (93.22%), negative predictive value (91.67%) and positive predictive value (75.19%). Conclusion: We concluded that FNA provides a good predictive value for benign thyroid, constituting a reliable and effective tool for diagnosis and surgical indication.

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Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy between fine needle aspiration biopsy (FNA) and pathological examination of the thyroid

Menegassi¹,

Bordin²,

Oliveira³

2013

J. Bras. Patol. Med. Lab.

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“…Molecular markers are promising but they have not yet been sufficiently validated to be used in clinical practice [7,8]. The role of clinical evaluation of patients who have thyroid nodule is to minimize the risk of overlooking thyroid cancer.…”

Section: Introductionmentioning

confidence: 99%

Role of ultrasound, clinical and scintigraphyc parameters to predict malignancy in thyroid nodule

et al. 2011

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BackgroundThis study aimed to evaluate clinical, laboratory, ultrasound (US) and scintigraphyc parameters in thyroid nodule and to develop an auxiliary model for clinical application in the diagnosis of malignancy.MethodsWe assessed 143 patients who were surgically treated at a single center, 65% (93) benign vs. 35% (50) malignant lesions at final histology (1998-2008). The clinical, laboratory, scintigraphyc and US features were compared and a prediction model was designed after the multivariate analysis.ResultsThere were no differences in gender, serum TSH and FT4 levels, thyroid auto-antibodies (TAb), thyroid dysfunction and scintigraphyc results (P = 0.33) between benign and malignant nodule groups. The sonographic study showed differences when the presence of suspected characteristics was found in the nodules of the malignant lesions group, such as: microcalcifications, central flow, border irregularity and hypoechogenicity. After the multivariate analysis the model obtained showed age (>39 years), border irregularity, microcalcifications and nodule size over 2 cm as predictive factors of malignancy, featuring 81.7% of accuracy.ConclusionsThis study confirmed a significant increase of risk for malignancy in patients of over 39 years and with suspicious features at US.

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“…They are the most frequent malignant alterations of the endocrine system and the number of cases has progressively increased over the last few years (1). The annual incidence of thyroid nodules clinically detected in adults is estimated at 0.1%, with a prevalence of 4–7% in investigations using palpation, 30–50% in series that use ultrasound and 50% in autopsies (2,3). Fine-needle aspiration (FNA) represents the main pre-operative tool for diagnosing thyroid nodules, due to its technical simplicity and low cost and a reported sensitivity and specificity of 70–98 and 55–100%, respectively (4).…”

Section: Introductionmentioning

confidence: 99%

Contribution of the BRAF oncogene in the pre-operative phase of thyroid carcinoma

2013

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Numerous experiments have been conducted over the last few years aiming to identify molecular markers that show the diagnostic accuracy of fine-needle aspiration (FNA), particularly in thyroid lesions that are considered indeterminate. Using certain search arguments and previously defined criteria, 37 studies reporting experiments with the BRAF mutation in pre-operative FNA of the thyroid were selected from the electronic databases PUBMED, MEDLINE, SCOPUS and LILACS, in order to gather evidence with regard to the possible contribution of BRAF in the management of thyroid carcinoma. There were no cases positive for BRAF in follicular carcinomas (FTCs), Hürthle cell carcinomas (HCCs) or medullary thyroid carcinomas (MTCs). Among the 11 cases of anaplastic thyroid carcinomas (ATC), three showed positive results for the BRAF mutation. The number of cases positive for BRAF among the benign lesions was not significant. The average prevalence of BRAF-positive cases in papillary carcinomas (PTC) was 58.6%, while in follicular variants of papillary carcinoma (FVPTC), the average prevalence was 29.6%. For lesions diagnosed as indeterminate or suspicious, the average prevalence of BRAF positivity in PTC was 48.5%. The experiments included in the present study indicated a specificity of almost 100% and a high predominance of the BRAF mutation in PTC, distinguishing the marker in the planning and medical management of papillary carcinoma of the thyroid.

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Nódulos com diagnóstico de padrão folicular: marcadores biológicos são o futuro?

Cited by 10 publications

References 63 publications

Diagnostic accuracy between fine needle aspiration biopsy (FNA) and pathological examination of the thyroid

Diagnostic accuracy between fine needle aspiration biopsy (FNA) and pathological examination of the thyroid

Role of ultrasound, clinical and scintigraphyc parameters to predict malignancy in thyroid nodule

Contribution of the BRAF oncogene in the pre-operative phase of thyroid carcinoma

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