Atypical Histiocytoid Cells and Multinucleated Giant Cells in Fine-Needle Aspiration Cytology of the Thyroid Predict Lymph Node Metastasis of Papillary Thyroid Carcinoma

Cancers - Tập 11 Số 6 - Trang 816
Ji Eun Choi1,2, Ja Seong Bae3,4, Dong‐Jun Lim3,5, So Lyung Jung6, Chan Kwon Jung3,1
1Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
2Department of Pathology, Design Hospital, Jeonju-si, Jeollabuk-do 54910, Korea
3Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
4Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
5Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
6Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea

Tóm tắt

Preoperative detection of cervical lymph node metastasis in papillary thyroid carcinoma (PTC) is crucial for determining the surgical strategy to prevent locoregional recurrence of the disease. We identified the cytological predictors of lymph node metastasis in 222 consecutive patients with PTC using fine-needle aspiration cytology (FNAC) of the thyroid. Cervical lymph node metastases occurred in 99 (44.6%) of 222 PTC patients. Lymph node metastasis was significantly associated with tumor multifocality (p = 0.003), and high cellularity (p = 0.021), atypical histiocytoid cells (p < 0.001), and multinucleated giant cells (p < 0.001) in thyroid FNAC. The BRAF V600E mutation was marginally associated with lymph node metastasis (p = 0.054). Multivariate analysis revealed that atypical histiocytoid cells (odds ratio = 2.717; p = 0.001) and multinucleated giant cells (odds ratio = 3.070; p = 0.031) were independent predictors of lymph node metastasis in patients with PTC. In a subgroup analysis of 164 patients with microcarcinomas, atypical histiocytoid cells (odds ratio = 2.761; p = 0.005) was an independent predictor of lymph node metastasis. Cytological detection of atypical histiocytoid cells and multinucleated giant cells on thyroid FNAC can be used to preoperatively predict cervical lymph node metastasis in patients with PTC.

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Tập 11 Số 6

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