Araştırma Makalesi
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The Predictive Factors of Malignancy in Follicular Lesion of Undeterminated Significance

Yıl 2023, Cilt: 10 Sayı: 1, 15 - 18, 10.04.2023
https://doi.org/10.47572/muskutd.1039741

Öz

Follicular lesion of undetermined significance (FLUS) is defined in the same Group III with the atypia of undetermined significance according to Bethesda Classification but these subgroups have different malignancy rates and tumor characteristics according to the studies. In this study, the aim was to evaluate the preoperative clinicopathologic features of the patients with cytological Bethesda Category III/FLUS thyroid nodules. The 44 patients were divided into two groups based on fine needle aspiration cytology (FNAC) results as benign (pB) and malignant (pM) and compared the preoperative clinical, ultrasonographic findings and FNAC results of two groups. According to the univariate analyses the presence of hiopechogenicity and presence of microcalcification are found to be significantly higher in malignancy (p<0.05 for all). Also, the presence of microcalcifications (p=0.048), and hypoechogenicity (p=0.014) were found to be independent risk factors for malignancy according to logistic regression analysis. In patients with FLUS, it should be remembered that the incidence of malignancy increases and treatment should be considered in the forefront of surgery instead of recurrent FNAC in the presence of hypoechogenicity and microcalcification in ultrasonography, and in patients with nuclear membrane irregularity according to FNAC.

Kaynakça

  • 1. Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association (ATA) guidelines taskforce on thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167-214.
  • 2. Cibas ES and Ali SZ. The Bethesda system for reporting thyroid cytopathology. Thyroid. 2009;19(11):1159-65.
  • 3. Wang HH. Reporting thyroid fine‐needle aspiration: literature review and a proposal. Diagn Cytopathol. 2006;34(1):67-76.
  • 4. Ho AS, Sarti EE, Jain KS, et al. Malignancy rate in thyroid nodules classified as Bethesda category III (AUS/FLUS). Thyroid, 2014;24(5):832-9.
  • 5. VanderLaan PA, Marqusee E, Krane JF. Clinical outcome for atypia of undetermined significance in thyroid fine-needle aspirations: should repeated FNA be the preferred initial approach?. Am J Clin Pathol. 2011;135(5):770-5.
  • 6. Horne MJ, Chhieng DC, Theoharis C, et al. Thyroid follicular lesion of undetermined significance: Evaluation of the risk of malignancy using the two‐tier sub‐classification. Diagn. Cytopathol. 2012;40(5):410-5.
  • 7. Cakir B, Bilginer M, Ozdemir D, et al. Hemithyroidectomy Seems to be a Reasonable Initial Surgical Approach in Patients with Cytological Bethesda Category III Thyroid Nodules: An Institutional Experience. Turk J Endocrinol Metab. 2018;22(2):57-63.
  • 8. Hosmer Jr DW, Lemeshow S, Sturdivant RX. Applied logistic regression. John Wiley & Sons, 2013.
  • 9. Yoon JH, Kwon HJ, Kim EK, et al. Subcategorization of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS): a study applying Thyroid Imaging Reporting and Data System (TIRADS). Clin Endocrinol. 2016;85(2):275-82.
  • 10. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1-133.
  • 11. Topaloglu O, Baser H, Cuhaci FN, et al. Malignancy is associated with microcalcification and higher AP/T ratio in ultrasonography, but not with Hashimoto’s thyroiditis in histopathology in patients with thyroid nodules evaluated as Bethesda Category III (AUS/FLUS) in cytology. Endocrine. 2016;54(1):156-68.
  • 12. Marques RR, Rafael AA, Santos FS, et al. Can we predict malignancy in AUS/FLUS by measuring TSH? In: Endocrine Abstracts. Bioscientifica, 2016.

Önemi Belirsiz Foliküler Lezyonda Malignitenin Prediktif Faktörleri

Yıl 2023, Cilt: 10 Sayı: 1, 15 - 18, 10.04.2023
https://doi.org/10.47572/muskutd.1039741

Öz

Önemi belirsiz folliküler lezyon (ÖBFL) Bethesda Sınıflamasına göre önemi belirsiz atipi ile aynı üçüncü grupta tanımlanmıştır, ancak bu alt gruplar yapılan çalışmalara göre farklı malignite oranlarına ve tümör özelliklerine sahiptir. Bu çalışmada sitolojik olarak Bethesda Kategori III/ÖBFL tiroid nodüllü hastaların preoperatif klinikopatolojik özelliklerinin değerlendirilmesi amaçlandı. 44 hasta ince iğne aspirasyon sitolojisi (İİAS) sonuçlarına göre benign (pB) ve malign (pM) olarak iki gruba ayrıldı ve iki grubun ameliyat öncesi klinik, ultrasonografik bulguları ve İİAS sonuçları karşılaştırıldı. Tek değişkenli analizlere göre İİAS'ye göre hiopekojenite, mikrokalsifikasyon varlığı ve düzensiz çekirdek varlığı malignitede anlamlı olarak daha yüksek bulundu (tümü için p<0,05). Ayrıca mikrokalsifikasyonlar (p=0,048) ve hipoekojenite (p=0,014) lojistik regresyon analizine göre malignite için bağımsız risk faktörleri olarak bulundu. ÖBFL'li hastalarda ultrasonografide hipoekojenite ve mikrokalsifikasyon varlığında, tekrarlayan İİAS yerine malignite insidansının arttığı ve cerrahinin ön planda düşünülmesi gerektiği unutulmamalıdır.

Kaynakça

  • 1. Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association (ATA) guidelines taskforce on thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167-214.
  • 2. Cibas ES and Ali SZ. The Bethesda system for reporting thyroid cytopathology. Thyroid. 2009;19(11):1159-65.
  • 3. Wang HH. Reporting thyroid fine‐needle aspiration: literature review and a proposal. Diagn Cytopathol. 2006;34(1):67-76.
  • 4. Ho AS, Sarti EE, Jain KS, et al. Malignancy rate in thyroid nodules classified as Bethesda category III (AUS/FLUS). Thyroid, 2014;24(5):832-9.
  • 5. VanderLaan PA, Marqusee E, Krane JF. Clinical outcome for atypia of undetermined significance in thyroid fine-needle aspirations: should repeated FNA be the preferred initial approach?. Am J Clin Pathol. 2011;135(5):770-5.
  • 6. Horne MJ, Chhieng DC, Theoharis C, et al. Thyroid follicular lesion of undetermined significance: Evaluation of the risk of malignancy using the two‐tier sub‐classification. Diagn. Cytopathol. 2012;40(5):410-5.
  • 7. Cakir B, Bilginer M, Ozdemir D, et al. Hemithyroidectomy Seems to be a Reasonable Initial Surgical Approach in Patients with Cytological Bethesda Category III Thyroid Nodules: An Institutional Experience. Turk J Endocrinol Metab. 2018;22(2):57-63.
  • 8. Hosmer Jr DW, Lemeshow S, Sturdivant RX. Applied logistic regression. John Wiley & Sons, 2013.
  • 9. Yoon JH, Kwon HJ, Kim EK, et al. Subcategorization of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS): a study applying Thyroid Imaging Reporting and Data System (TIRADS). Clin Endocrinol. 2016;85(2):275-82.
  • 10. Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1-133.
  • 11. Topaloglu O, Baser H, Cuhaci FN, et al. Malignancy is associated with microcalcification and higher AP/T ratio in ultrasonography, but not with Hashimoto’s thyroiditis in histopathology in patients with thyroid nodules evaluated as Bethesda Category III (AUS/FLUS) in cytology. Endocrine. 2016;54(1):156-68.
  • 12. Marques RR, Rafael AA, Santos FS, et al. Can we predict malignancy in AUS/FLUS by measuring TSH? In: Endocrine Abstracts. Bioscientifica, 2016.
Toplam 12 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Cerrahi
Bölüm Araştırma Makalesi
Yazarlar

Samet Şahin 0000-0003-0748-3458

Hikmet Pehlevan Özel 0000-0002-9146-3742

Yunus Yuksek 0000-0003-0442-8410

Tanju Tütüncü 0000-0001-9058-465X

Yayımlanma Tarihi 10 Nisan 2023
Gönderilme Tarihi 22 Aralık 2021
Yayımlandığı Sayı Yıl 2023 Cilt: 10 Sayı: 1

Kaynak Göster

APA Şahin, S., Pehlevan Özel, H., Yuksek, Y., Tütüncü, T. (2023). The Predictive Factors of Malignancy in Follicular Lesion of Undeterminated Significance. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, 10(1), 15-18. https://doi.org/10.47572/muskutd.1039741
AMA Şahin S, Pehlevan Özel H, Yuksek Y, Tütüncü T. The Predictive Factors of Malignancy in Follicular Lesion of Undeterminated Significance. MMJ. Nisan 2023;10(1):15-18. doi:10.47572/muskutd.1039741
Chicago Şahin, Samet, Hikmet Pehlevan Özel, Yunus Yuksek, ve Tanju Tütüncü. “The Predictive Factors of Malignancy in Follicular Lesion of Undeterminated Significance”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 10, sy. 1 (Nisan 2023): 15-18. https://doi.org/10.47572/muskutd.1039741.
EndNote Şahin S, Pehlevan Özel H, Yuksek Y, Tütüncü T (01 Nisan 2023) The Predictive Factors of Malignancy in Follicular Lesion of Undeterminated Significance. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 10 1 15–18.
IEEE S. Şahin, H. Pehlevan Özel, Y. Yuksek, ve T. Tütüncü, “The Predictive Factors of Malignancy in Follicular Lesion of Undeterminated Significance”, MMJ, c. 10, sy. 1, ss. 15–18, 2023, doi: 10.47572/muskutd.1039741.
ISNAD Şahin, Samet vd. “The Predictive Factors of Malignancy in Follicular Lesion of Undeterminated Significance”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 10/1 (Nisan 2023), 15-18. https://doi.org/10.47572/muskutd.1039741.
JAMA Şahin S, Pehlevan Özel H, Yuksek Y, Tütüncü T. The Predictive Factors of Malignancy in Follicular Lesion of Undeterminated Significance. MMJ. 2023;10:15–18.
MLA Şahin, Samet vd. “The Predictive Factors of Malignancy in Follicular Lesion of Undeterminated Significance”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, c. 10, sy. 1, 2023, ss. 15-18, doi:10.47572/muskutd.1039741.
Vancouver Şahin S, Pehlevan Özel H, Yuksek Y, Tütüncü T. The Predictive Factors of Malignancy in Follicular Lesion of Undeterminated Significance. MMJ. 2023;10(1):15-8.