Differentiation of the Follicular Variant of Papillary Thyroid Carcinoma From Classic Papillary Thyroid Carcinoma: An Ultrasound Analysis and Complement to Fine‐Needle Aspiration Cytology

Journal of Ultrasound in Medicine - Tập 37 Số 3 - Trang 667-674 - 2018
Soh‐Ching Ng1, Sheng‐Fong Kuo1, Chung‐Ching Hua2, Bie‐Yu Huang1, Kun‐Chun Chiang3, Yin‐Yi Chu4, Chuen Hsueh5, Jen‐Der Lin6
1Departments of Endocrinology and Metabolism, Chang Gung Memorial Hospital, Keelung, Chang Gung University, Taoyuan Hsien, Taiwan
2Departments of Internal Medicine, Chang Gung Memorial Hospital, Keelung, Chang Gung University, Taoyuan Hsien, Taiwan
3Departments of General Surgery, Chang Gung Memorial Hospital, Keelung, Chang Gung University, Taoyuan Hsien, Taiwan
4Departments of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Chang Gung University, Taoyuan Hsien, Taiwan
5Departments of Pathology, Chang Gung Memorial Hospital, Linkou, Chang Gung University, Taoyuan Hsien, Taiwan
6Departments of Endocrinology and Metabolism, Chang Gung Memorial Hospital, Linkou, Chang Gung University, Taoyuan Hsien, Taiwan

Tóm tắt

ObjectivesIt is difficult to establish a diagnosis of the follicular variant of papillary thyroid carcinoma (PTC) using fine‐needle aspiration cytology (FNAC). Preoperative features on ultrasound (US) imaging are different between follicular PTC and classic PTC. This study developed a risk score system to differentiate follicular PTC from classic PTC and to correlate the risk score of follicular PTC with its FNAC categories and pathologic features.MethodsThe US features, FNAC results, and pathologic reports of 156 follicular PTC nodules and 152 classic PTC nodules from 296 patients with PTC along with their clinical characteristics were reviewed retrospectively. A risk score system based on US features was developed by multivariate logistic regression to differentiate classic PTC from follicular PTC nodules. The risk scores were then correlated with the FNAC category and pathologic features of the nodules.ResultsThe US risk score (5 × echogenicity + 3 × calcifications + 3 × marginal regularity) had an area under the receiver operating characteristic curve of 0.85 and a cutoff value of 8.0, with specificity of 87% and sensitivity of 69% for predicting a classic PTC nodule. The follicular PTC nodules with low Bethesda categorization (I–III) had a median US risk score of 6 (range, 0–11), which was higher than that of nodules with high categorization (IV–VI; median, 3; range, 0–11).ConclusionsThe US risk score may be useful in differentiating classic PTC from follicular PTC and complementary to FNAC in identifying follicular PTC.

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Thông tin xuất bản

Journal of Ultrasound in Medicine

Tập 37 Số 3

667-674

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