A Diagnostic Predictor Model for Indeterminate or Suspicious Thyroid FNA Samples
- 1 September 2008
- journal article
- research article
- Published by Mary Ann Liebert Inc in Thyroid®
- Vol. 18 (9), 933-941
- https://doi.org/10.1089/thy.2008.0108
Abstract
Background: The management of patients with thyroid fine-needle aspiration (FNA) specimens that are neither benign nor malignant still remains problematic. Efforts to improve their management have focused on identifying risk factors that predict malignancy. This study seeks to identify clinical and tumor characteristics that predict thyroid malignancy among patients with indeterminate or suspicious FNA and to develop a diagnostic predictor model. Methods: The records of 639 patients with an indeterminate or suspicious thyroid FNA between January 1995 and April 2005 were reviewed. Patient and tumor characteristics were evaluated for their potential to predict malignancy in the final surgical histopathology. A diagnostic predictor model was designed based on statistically significant predictors. Patients seen between April 2005 and April 2007 were used to validate the model. Results: Patient age, nodule size, and FNA cytopathology were identified as risk factors. Patients at extremes of age were at increased risk. Patients 50 years of age had the lowest risk of malignancy. For patients less than age 50, the risk increased 3% for each year decrease in age (p = 0.001). After 50, the risk increased 3.4% for each year increase in age (p = 0.016). Nodules 2.5 cm had the lowest likelihood of malignancy. For smaller nodules, the risk increased 53% per cm decrease in size (p < 0.001). For larger nodules, the risk increased 39% per cm increase (p < 0.001). Patients with FNA cytology suspicious for papillary thyroid carcinoma had the greatest risk of malignancy (p < 0.001). Conclusions: A predictor model was created using the variables age, nodule size, and FNA cytology to predict thyroid malignancy.Keywords
This publication has 25 references indexed in Scilit:
- The National Cancer Institute Thyroid Fine Needle Aspiration State of the Science Conference: a SummationCytojournal, 2008
- No Apparent Damage in the Thyroid of Transgenic Mice Expressing Antiapoptotic FLIPThyroid®, 2006
- Fine-needle aspiration biopsy specimen with a predominance of Hürthle cells: A dilemma in the management of nodular thyroid diseaseSurgery, 2005
- Thyroid papillary cancers: microcarcinoma and carcinoma, incidental cancers and non‐incidental cancers – are they different diseases?Clinical Endocrinology, 2005
- Does the fine‐needle aspiration diagnosis of “Hürthle‐cell neoplasm/follicular neoplasm with oncocytic features” denote increased risk of malignancy?Diagnostic Cytopathology, 2004
- The Utility of Frozen Section Evaluation for Follicular Thyroid LesionsAnnals of Surgical Oncology, 2003
- Thyroid Cytology and the Risk of Malignancy in Thyroid Nodules: Importance of Nuclear Atypia in Indeterminate SpecimensThyroid®, 2001
- Risk Factors for Malignancy of Thyroid Nodules Initially Identified as Follicular Neoplasia by Fine-Needle Aspiration: Results of a Prospective Study of One Hundred Twenty PatientsThyroid®, 2000
- Hürthle Cell Neoplasms of the ThyroidAnnals of Surgery, 1998
- “Suspicious” Thyroid Cytologic Findings: Outcome in Patients Without Immediate Surgical TreatmentMayo Clinic Proceedings, 1993