Role of Ultrasound in Predicting Tumor Invasiveness in Follicular Variant of Papillary Thyroid Carcinoma
- Authors
- Hahn, SY[Hahn, Soo Yeon]; Shin, JH[Shin, Jung Hee]; Oh, YL[Oh, Young Lyun]; Kim, TH[Kim, Tae Hyuk]; Lim, Y[Lim, Yaeji]; Choi, JS[Choi, Ji Soo]
- Issue Date
- Sep-2017
- Publisher
- MARY ANN LIEBERT, INC
- Keywords
- follicular variant of papillary thyroid carcinoma; NIFTP; ultrasound; K-TIRADS; ATA
- Citation
- THYROID, v.27, no.9, pp.1177 - 1184
- Indexed
- SCIE
SCOPUS
- Journal Title
- THYROID
- Volume
- 27
- Number
- 9
- Start Page
- 1177
- End Page
- 1184
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/27447
- DOI
- 10.1089/thy.2016.0677
- ISSN
- 1050-7256
- Abstract
- Background: Follicular variant of papillary thyroid carcinoma (FVPTC) is traditionally divided into infiltrative and encapsulated types. Adding to this classification, noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) represents a reclassification of a subset of cases (encapsulated tumors without lymphovascular or capsular invasion). The purpose of this study was to assess the role of ultrasound (US) in predicting tumor invasiveness in FVPTC. Methods: From January 2014 to May 2016, preoperative US examinations were performed on 151 patients with 152 FVPTCs who underwent surgery. Based on a pathologic analysis, the FVPTCs were categorized into three groups: NIFTP, invasive encapsulated FVPTC (iE-FVPTC), or infiltrative FVPTC (I-FVPTC). Each nodule was categorized based on the US pattern according to the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) and the American Thyroid Association (ATA) guidelines. The correlation between tumor invasiveness and the K-TIRADS or ATA category was investigated using Spearman's rank correlation coefficient. Results: Among the 152 FVPTCs, there were 48 (31.6%) NIFTPs, 60 (39.5%) iE-FVPTCs, and 44 (28.9%) I-FVPTCs. US characteristics of the FVPTCs differed significantly according to tumor invasiveness (p <= 0.030). Tumor invasiveness showed a significant positive correlation with K-TIRADS (tumors of all sizes: r = 0.591, p < 0.001; tumors >= 1.0 cm: r = 0.427, p < 0.001) and ATA categories (tumors of all sizes: r = 0.532, p < 0.001; tumors >= 1.0 cm: r = 0.466, p < 0.001). According to both K-TIRADS and ATA guidelines for all-sized tumors, the most common subtype was NIFTP in low-suspicion nodules (52.6% and 51.6%), iE-FVPTC in intermediate-suspicion nodules (52.7% and 54.2%), and I-FVPTC in high-suspicion nodules (82.5% and 69.4%). After surgery, lymph node metastases were confirmed in two (4.2%) NIFTP cases, three (5.0%) iE-FVPTC cases, and eight (18.2%) I-FVPTC cases (p = 0.001). The results of the BRAF mutation analysis were not significantly different between the groups (p = 0.507). Conclusions: Increasing tumor invasiveness from NIFTP to iE-FVPTC to I-FVPTC is positively correlated with the level of suspicion on US using both K-TIRADS and ATA guidelines.
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Collections - Medicine > Department of Medicine > 1. Journal Articles
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