Thyroid cancer detection rate and associated risk factors in patients with thyroid nodules classified as Bethesda category III

Mileva, Magdalena; Stoilovska, Bojana; Jovanovska, Aleksandra; Ugrinska, Ana; Petrushevska, Gordana; Kostadinova-Kunovska, Slavica; Miladinova, Daniela; Majstorov, Venjamin

doi:10.2478/raon-2018-0039

Cited by 25 publications

(20 citation statements)

References 29 publications

(33 reference statements)

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“…Among the 180 cases involved in our study, females were the majority, 82.8% (n = 149). This finding is similar to recent studies done in Finland [9], Macedonia [10], and North America [11,12]. The age group in our study was around 45.09 ± 14.7, which was comparable to a study in Thailand [13], but it was a decade younger than what was reported in other studies [10][11][12].…”

Section: Discussionsupporting

confidence: 92%

Incidence, Clinical Characteristics, and Histopathological Results of Atypia of Undermined Significance in a Tertiary Center in UAE

Shangab

Khalifa

Awadi

et al. 2021

Dubai Diabetes Endocrinol J

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Introduction: Bethesda classification of thyroid nodules cytology is an agreed upon method of classifying thyroid nodules according to risk of malignancy. Among them, Bethesda class III (Atypia of Undetermined Significance, AUS) has been a topic of great controversy. The reported estimated risk of malignancy associated with it varies in different studies. Our study investigates the associated incidence of malignancy in a single tertiary center in UAE. Methodology: Data were retrospectively collected over a 10-year period from January 2009 till December 2018 for cytology diagnosis of AUS. Patient charts were reviewed for method of management. Surgical and histopathology records were reviewed to compare findings on cytology versus histopathology. Results: A total of 180 cases were diagnosed Bethesda III (AUS) with a mean age of 45.09 ± 14.7 years. One hundred cases (55.6%) of them underwent surgical resection, and histopathological diagnosis was obtained. Among the operated cases, 46 were benign and 54 were malignant. Papillary thyroid cancer was the most common malignancy, seen in 39 (72.2%) of cases, and follicular cancer was the second most common, seen in 13 (24.1%) cases. Conclusion: The findings highlighted in our study suggest a higher incidence of malignancy in Bethesda III category than previously reported. It also puts in question the utility and benefit behind keeping a time gap and repeating FNA as previously recommended.

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Section: Discussionsupporting

confidence: 92%

Incidence, Clinical Characteristics, and Histopathological Results of Atypia of Undermined Significance in a Tertiary Center in UAE

Shangab

Khalifa

Awadi

et al. 2021

Dubai Diabetes Endocrinol J

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“…On the malignancy risk of TBSIII thyroid nodule, it is 10-30% indicated from the 2017 TBS, while in some studies, it is 31.2% [9] in the diagnosis of FNA conventional smears and up to 36.2% [10] in the diagnosis of sedimentation smears. In this study, a total of 221 cases were compared and analyzed from the results of the ultrasound-guided FNAC diagnosis under different LBP methods and corresponding histological diagnosis.…”

Section: Discussionmentioning

confidence: 98%

A comparative study of two liquid-based preparation methods: membrane-based and sedimentation in fine needle aspiration cytology diagnosis in thyroid nodules

et al. 2020

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Background As thyroid fine needle aspiration (FNA) shows a certain limitation in the diagnosis of conventional smears, novel approaches like liquid-based cytology (LBC) have been gradually applied recently. Studies have shown the difference between the conventional smears (CSs) and liquid-based smears on fine needle aspiration cytology (FNAC) diagnosis, but the impacts of different liquid-based preparation (LBP) methods, including membrane-based and sedimentation, on diagnosis are still not clear. In this study, the effects of liquid-based smears prepared by different methods on the cytological interpretation were studied. Methods A total of 221 thyroid liquid-based FNAC cases from January 2017 to October 2018 were collected. We retrospectively studied and compared the effects of the membrane-based and sedimentation LBP methods through The Bethesda System for Reporting Thyroid Cytopathology (TBS) diagnosis and risk of malignancy assessment. Besides, we made an evaluation on the diagnostic differences in the effects of different preparation methods on the cell morphology and tissue structure of papillary thyroid carcinoma (PTC) for more accurate FNAC diagnosis. Results Among the 221 cases reviewed, membrane-based method was applied in 153 cases and sedimentation in 68 cases. According to the diagnostic criteria of 2017 TBS, TBSVI and TBSV thyroid could be cytologically diagnosed by membrane-based (49.0% (75/153) and 25.5% (39/153)) and sedimentation (52.9(36/68) and 25(17/68)) methods, and both were confirmed as PTC through histopathological diagnosis after operation, with the malignancy degree as high as 100%. In addition, of the 30 cases that were diagnosed as TBSIII thyroid nodules with the membrane-based method, 15 cases were pathologically malignant after an operation, with the malignancy degree of 50% (15/30), while that in 11 cases using the sedimentation method was 45.4% (5/11). PTC could be detected in both the TBSIV and TBSII thyroid nodules diagnosed by membrane-based method, with the sensitivity of 87.0% (114/131) lower than that by sedimentation method (91.4% (53/58)), showing the lower consistency with the histopathological result (K = 0.635 vs K = 0.757). Among the membrane-based smears, 23.5% (36/153) had fewer follicular epithelial cells, 55.6% (20/36) of which were considered to be suspicious for PTC from cell karyotype and tissue arrangement. While among the sedimentation smears, 16.2% (11/68) had fewer follicular epithelial cells, and 63.6% (7/11) was suspicious for PTC. In 72.5% (95/131) membrane-based smears of PTC, the papillary and swirling structures were not obvious, showing as crowded syncytial cell masses, while in 55.2% (32/58) sedimentation smears, both structures were visible with obvious three-dimensional papillary structure, and the fibrovascular axis still remained. Conclusion LBP technique is feasible for FNAC diagnosis, and the sedimentation shows more advantages, like higher PTC detection rate and good consistency with postoperative histopathological diagnosis. A clear understanding of the subtle differences in the effects of membrane-based and sedimentation methods on the cell morphology and tissue structure could be conducive to the definitive diagnosis of PTC before operation.

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“…The risk of malignancy after surgery is reported to be 14% (6-48) (15) . Mileva et al (16) reported that, thyroid cancer was detected in 35 (31.2%) of 112 patients whose FNA biopsy results were reported as ACUS, and 77 (68.8%) of them were found to be benign. Kuru et al (17) reported that 22.9% of 179 patients whose FNA biopsy was reported as ACUS were diagnosed as having malign pathology after the surgery.…”

Section: Discussionmentioning

confidence: 99%

Are MicroRNA 190 and MicroRNA95-3P in the Circulation Can Be Used As Predictive Bioindicators in Differentiated Thyroid Cancer in Patients with Atypia of Undetermined Significance Based on Thyroid Fine Needle Aspiration Biopsy Results?

Ünsal¹,

Cartı²,

Ünübol³

et al. 2020

Terh

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INTRODUCTION: It is not always possible to make a definitive diagnosis preoperatively with thyroid fine needle aspiration biopsy. Decision making is quite complicated in cases with atypical cells of undetermined significance. MicroRNAs have been shown to be associated with the development of neoplasia. For this purpose, we aimed to investigate the circulating microRNA 190 and microRNA 95-3P levels as a biomarker to distinguish benign and malign cases with preoperative atypical cells of undetermined significance diagnosis. METHODS: Patients with preoperative atypical cells of undetermined significance.diagnosis were included in the study. 29 malign and 29 benign patients were included. Venous blood samples isolated using a specific miRNA kit. RESULTS: According to the postoperative pathology results statistically significant between circulating miRNA 190 and miRNA 95-3p between cases with thyroid cancer. differences were detected. DISCUSSION AND CONCLUSION: It can be asserted that miRNA 95 and miRNA 190 assessment can help to differentiate thyroid cancer from benign thyroid nodules and may be useful in avoiding unnecessary surgery in patients with atypical cells of undetermined significance results.

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Thyroid cancer detection rate and associated risk factors in patients with thyroid nodules classified as Bethesda category III

Cited by 25 publications

References 29 publications

Incidence, Clinical Characteristics, and Histopathological Results of Atypia of Undermined Significance in a Tertiary Center in UAE

Incidence, Clinical Characteristics, and Histopathological Results of Atypia of Undermined Significance in a Tertiary Center in UAE

A comparative study of two liquid-based preparation methods: membrane-based and sedimentation in fine needle aspiration cytology diagnosis in thyroid nodules

Are MicroRNA 190 and MicroRNA95-3P in the Circulation Can Be Used As Predictive Bioindicators in Differentiated Thyroid Cancer in Patients with Atypia of Undetermined Significance Based on Thyroid Fine Needle Aspiration Biopsy Results?

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