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Thyroid cancer detection rate and associated risk factors in patients with thyroid nodules classified as Bethesda category III Cover

Thyroid cancer detection rate and associated risk factors in patients with thyroid nodules classified as Bethesda category III

Open Access
|Sep 2018

Figures & Tables

Figure 1

Histologic outcomes of Bethesda Category III nodules from patients who underwent direct surgical treatment. Malignancies were found in 36.1% of AUS/FLUS nodules who were managed with surgery without a repeat cytology. Papillary Thyroid Carcinoma and its Follicular variant were the most common types of cancer, accounting for a total of 83.9% of all malignancies. Among the benign lesions, Follicular adenomas presented in 50% of these cases, and Nodular hyperplasia was second in line with a frequency of 31.5%.
Histologic outcomes of Bethesda Category III nodules from patients who underwent direct surgical treatment. Malignancies were found in 36.1% of AUS/FLUS nodules who were managed with surgery without a repeat cytology. Papillary Thyroid Carcinoma and its Follicular variant were the most common types of cancer, accounting for a total of 83.9% of all malignancies. Among the benign lesions, Follicular adenomas presented in 50% of these cases, and Nodular hyperplasia was second in line with a frequency of 31.5%.

Comparison of clinical data of benign and malignant thyroid nodules in 105 patients with Bethesda III cytology report

VariablesFinal outcomep-value
Benign (n = 71)Malignant (n = 34)
Age (y),54.9 ± 11.7

mean ± standard deviation; n = number of patients; OR = odds ratio; ns = non significant.

48 ± 14.2

mean ± standard deviation; n = number of patients; OR = odds ratio; ns = non significant.

< 0.01 (0.005)
range(25–77)(24–71)OR 0.953 (95% CI 0.922–0.986)
Genderns (0,506)
 Male14 (19.7%)4 (11.7%)
 Female57 (80.3%)30 (88.3%)
Nodule size (mm),24.6 ± 9.1

mean ± standard deviation; n = number of patients; OR = odds ratio; ns = non significant.

20.7 ± 9.8

mean ± standard deviation; n = number of patients; OR = odds ratio; ns = non significant.

< 0.05 (0.048)
range(10–60)(8–47)OR 0.952 (95% CI 0.907-1.00)
Thyroid scannumber of nodules:ns (0.117)
 Hypofunctioning (Cold)10 (23.8%)9 (50.0%)
 Isofunctioning25 (59.5%)9 (50.0%)
 Hyperfunctioning (Hot)7 (16.7%)0 (0.0%)

Clinical data of patients and US features of Bethesda category III nodules

Variables
Patients, n105
Age (y), range52,9 ± 12,7

Mean ± standard deviation

(24–77)
Gender
 Male1817.10%
 Female8782.90%
Thyroid nodules, n (total)112
 Benign7768.8%
 Malignant3531.2%
Nodule size (mm), range23,4 ± 9,4

Mean ± standard deviation

(8–60)
US features
 Composition
 Solid8374.1%
 Mixed2522.3%
 Cystic43.6%
 Echogenicity
 Anechoic32.7%
 Hypoechoic5650.0%
 Isoechoic4742.0%
 Hyperechoic65.4%
 Calcifications
 No calcifications8878.6%
 Microcalcifications1715.2%
 Macrocalcifications76.3%
 Vascularisation
 No vascularisation201.,9%
 Low1816.1%
 Peripheral1614.3%
 Central5851.8%
Thyroid scan
 No scan5246.4%
 Hypofunctioning (Cold)1917.0%
 Isofunctioning3430.3%
 Hyperfunctioning (Hot)76.3%

Comparison of US features of benign and malignant thyroid nodules with Bethesda III cytology report

VariablesFinal outcome p-value
Benign n = 77 (68.8%)Malignant n = 35 (31.2%)
Compositionns (0.372)
 Solid54 (70.1%)29 (82.9%)
 Mixed20 (26.0%)5 (14.3%)
 Cystic3 (3.9%)1 (2.9%)
Echogenicity
 Anechoic3 (3.9%)0 (0.0%)ns (0.999)
 Hypoechoic31 (40.3%)25 (71.4%)< 0.01 (0.003) OR 3.710 (95% CI 1.565–8.795)
 Isoechoic38 (49.4%)9 (25.7%)< 0.05 (0.021) OR 0.355 (95% CI 0.147–0.856)
 Hyperechoic5 (6.5%)1 (2.9%)ns (0.216)
Calcifications
 No calcifications68 (88.3%)20 (57.1%)< 0.01 (0.000) OR 0.176 (95% CI 0.067–0.463)
 Microcalcifications8 (10.4%)9 (25.7%)< 0.05 (0.042) OR 2.986 (95% CI 1.041–8.564)
 Macrocalcifications1 (1.3%)6 (17.1%)< 0.05 (0.012) OR 15.724 (95% CI 1.814–136.318)
Vascularisation
 No vascularisation10 (13.0%)10 (28.6%)ns (0.051)
 Peripheral15 (19.5%)1 (2.9%)< 0.05 (0.046) OR 0.122 (95% CI 015–0.961)
 Central41 (53.2%)17 (48.6%)ns (0.646)
 Low11 (14.3%)7 (20%)ns (0.447)
DOI: https://doi.org/10.2478/raon-2018-0039 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Language: English
Page range: 370 - 376
Submitted on: Jun 19, 2018
|
Accepted on: Aug 23, 2018
|
Published on: Sep 27, 2018
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2018 Magdalena Mileva, Bojana Stoilovska, Anamarija Jovanovska, Ana Ugrinska, Gordana Petrushevska, Slavica Kostadinova-Kunovska, Daniela Miladinova, Venjamin Majstorov, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.