A Scoring Index For Predicting Thyroid Malignancies
Neslihan Çuhacı Seyrek1, Berna Evranos Ogmen1, Abbas Ali Tam1, Didem Ozdemir1, Oya Topaloglu1, Aylin Yazgan2, Ersin Gurkan Dumlu3, Reyhan Ersoy1, Bekir Cakir11Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University, Faculty of Medicine, Ankara, Turkey2Department of Pathology, Ankara City Hospital, Ankara, Turkey
3Department of General Surgery, Ankara Yildirim Beyazit University, Faculty of Medicine, Ankara, Turkey
INTRODUCTION: We evaluated ultrasonography (US) features of thyroid nodules ≤ 1 cm and > 1 cm and determined the features that might predict malignancy, also aimed to develop a new scoring system considering US features to avoid unnecessary fine-needle aspiration biopsy (FNAB), particularly for subcentimeter nodules.
METHODS: We retrospectively evaluated 2233 nodules of 1118 patients who underwent thyroidectomy. US features predictive for malignant histopathology were evaluated by multivariate logistic regression analysis. A US index score was calculated for each nodule considering these features.
RESULTS: 337 (15.11%) nodules were ≤1 cm, and 1896 (84.89%) were > 1 cm. In total, 173 (51.33%) of the ≤1 cm nodules were histopathologically benign, and 164 (48.67%) were malignant. Anteroposterior/transverse diameter (AP/T) ≥1, microcalcifications, macrocalcifications, and hypoechoic patterns were significantly more frequent in ≤1 cm malignant compared with benign nodules. Microcalcification, macrocalcification, hypoechoic and iso-hypoechoic patterns, and solid texture were significantly higher in the malignant than the benign group in > 1 cm nodules. The best cut-off of US index scores for discrimination of benign and malignant nodules were > 2 and > 4 for ≤1 cm and > 1 cm nodules, respectively.
DISCUSSION AND CONCLUSION: Our US scoring system may help clinicians and surgeons to select nodules for FNAB more accurately, particularly those sub-centimeter in size.
Makale Dili: İngilizce
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