Predictive index for carcinoma of thyroid nodules and its integration with fine‐needle aspiration cytology

Kuru, Bekir; Gülçelik, Neşe Ersöz; Gülçelik, Mehmet Ali; Dincer, Halil

doi:10.1002/hed.21049

Cited by 35 publications

(45 citation statements)

References 58 publications

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“…As previously reported, thyroid nodules are four times more in women than in men, [12] but the incidence of malignancy in male patients is approximately twice that found in females, a proportion that is similar to the previously reported study. [13] One paper revealed that age more than 60 years was associated with malignancy in STN by Simon et al, [14] which is seemingly in accordance with our study. They also revealed nodule size larger than 4 cm is more closely related to thyroid malignancy, but we could not support the view in our study.…”

Section: Discussionsupporting

confidence: 94%

Risk factors for malignancy in patients with solitary thyroid nodules and their impact on the management

Tai

Jin

et al. 2012

J Can Res Ther

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Section: Discussionsupporting

confidence: 94%

Risk factors for malignancy in patients with solitary thyroid nodules and their impact on the management

Tai

Jin

et al. 2012

J Can Res Ther

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“…Of these, 235 studies were retrieved for further investigation, and 41 studies (14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54) met the final selection criteria and were included in the analysis. All 41 studies were observational studies published in peer-reviewed journals between 1989 and 2012.…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

DIAGNOSIS IN ENDOCRINOLOGY: Quantification of cancer risk of each clinical and ultrasonographic suspicious feature of thyroid nodules: a systematic review and meta-analysis

Campanella

Ianni

Rota

et al. 2014

European Journal of Endocrinology

106

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Objective: In order to quantify the risk of malignancy of clinical and ultrasonographic features of thyroid nodules (TNs), we did a systematic review and meta-analysis of published studies. Methods: We did a literature search in MEDLINE for studies published from 1st January 1989 until 31st December 2012. Studies were considered eligible if they investigated the association between at least one clinical/ultrasonographic feature and the risk of malignancy, did not have exclusion criteria for the detected nodules, had histologically confirmed the diagnoses of malignancy, and had a univariable analysis available. Two reviewers independently extracted data on study characteristics and outcomes. Results: The meta-analysis included 41 studies, for a total of 29 678 TN. A higher risk of malignancy expressed in odds ratio (OR) was found for the following: nodule height greater than width (OR: 10.15), absent halo sign (OR: 7.14), microcalcifications (OR: 6.76), irregular margins (OR: 6.12), hypoechogenicity (OR: 5.07), solid nodule structure (OR: 4.69), intranodular vascularization (OR: 3.76), family history of thyroid carcinoma (OR: 2.29), nodule size R4 cm (OR: 1.63), single nodule (OR: 1.43), history of head/neck irradiation (OR: 1.29), and male gender (OR: 1.22). Interestingly, meta-regression analysis showed a higher risk of malignancy for hypoechoic nodules in iodine-sufficient than in iodine-deficient geographical areas. Conclusions: The current meta-analysis verified and weighed out each suspicious clinical and ultrasonographic TN feature. The highest risk was found for nodule height greater than width, absent halo sign, and microcalcifications for ultrasonographic features and family history of thyroid carcinoma for clinical features. A meta-analysis-derived grading system of TN malignancy risk, validated on a large prospective cohort, could be a useful tool in TN diagnostic work-up.

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“…In a prospective study of 571 patients, who underwent thyroidectomy, Kuru et al [12] found that nodule size ≥4 cm was associated with increased risk of malignancy compared with nodule size <4 cm. However, no difference in risk of malignancy was noted when a cut-off of 3 cm was used.…”

Section: Discussionmentioning

confidence: 99%

“…However, several authors have questioned the accuracy of fine-needle aspiration cytology (FNAC) in large nodules. Some surgeons recommend thyroidectomy for nodules ≥4 cm even in the setting of benign FNAC, due to increased risk of malignancy and increased false negative rates in large thyroid nodules [12131415]. Even more aggressive surgeons use a threshold of 3 cm [16].…”

Section: Introductionmentioning

confidence: 99%

Risk of Malignancy in Thyroid Nodules 4 cm or Larger

Megwalu

2017

Endocrinol Metab

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BackgroundSeveral authors have questioned the accuracy of fine-needle aspiration cytology (FNAC) in large nodules. Some surgeons recommend thyroidectomy for nodules ≥4 cm even in the setting of benign FNAC, due to increased risk of malignancy and increased false negative rates in large thyroid nodules. The goal of our study was to evaluate if thyroid nodule size is associated with risk of malignancy, and to evaluate the false negative rate of FNAC for thyroid nodules ≥4 cm in our patient population.MethodsThis is a retrospective study of 85 patients with 101 thyroid nodules, who underwent thyroidectomy for thyroid nodules measuring ≥4 cm.ResultsThe overall risk of malignancy in nodules ≥4 cm was 9.9%. Nodule size was not associated with risk of malignancy (odds ratio, 1.02) after adjusting for nodule consistency, age, and sex (P=0.6). The false negative rate for FNAC was 0%.ConclusionNodule size was not associated with risk of malignancy in nodules ≥4 cm in our patient population. FNAC had a false negative rate of 0. Patients with thyroid nodules ≥4 cm and benign cytology should not automatically undergo thyroidectomy.

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Predictive index for carcinoma of thyroid nodules and its integration with fine‐needle aspiration cytology

Abstract: Patients with malignant and suspicious FNAC findings and, among patients with follicular neoplasm and nondiagnostic FNAC findings, those with > or =2 risk factors should undergo surgery.

Cited by 35 publications

References 58 publications

Risk factors for malignancy in patients with solitary thyroid nodules and their impact on the management

Risk factors for malignancy in patients with solitary thyroid nodules and their impact on the management

DIAGNOSIS IN ENDOCRINOLOGY: Quantification of cancer risk of each clinical and ultrasonographic suspicious feature of thyroid nodules: a systematic review and meta-analysis

Risk of Malignancy in Thyroid Nodules 4 cm or Larger

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