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Evaluation of selected ultrasound features of thyroid nodules with atypia of undetermined significance/follicular lesion of undetermined significance for the Bethesda reporting system for thyroid cytology

Authors Kaliszewski K, Diakowska D, Wojtczak B, Forkasiewicz Z

Received 16 March 2018

Accepted for publication 18 April 2018

Published 23 July 2018 Volume 2018:10 Pages 2223—2229

DOI https://doi.org/10.2147/CMAR.S168409

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Nakshatri


Krzysztof Kaliszewski,1 Dorota Diakowska,2 Beata Wojtczak,1 Zdzisław Forkasiewicz1

1First Department and Clinic of General, Gastroenterological and Endocrine Surgery, Wroclaw Medical University, Wroclaw, Poland; 2Department of Nervous System Diseases, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland

Background and objective: The risk of malignancy from “atypia of undetermined significance/follicular lesion of undetermined significance” (AUS/FLUS) is estimated to lie between 5% and 15%; however, some authors suggest that the risk of malignancy in AUS/FLUS depends upon specific clinical situations. This was a retrospective study which aimed to determine the incidence and risk of thyroid cancer (TC) based upon selected ultrasound features from patients with thyroid nodules (TN) classified as AUS/FLUS. 
Methods: Univariate and multivariate logistic regression analyses were used to identify significant associations between ultrasound features and the risk of TC.
Results: Of 127 patients with TN classified as AUS/FLUS who underwent thyroidectomy, 114 (89.8%) had benign disease while 13 (10.2%) had TC. Univariate analysis identified several significant predictors for TC (all p<0.05), including microcalcifications, hypoechogenicity, the prevalence of irregular margins, a taller rather than a wide form, high vascularity, and fast tumor growth. Multivariate analysis further showed that microcalcifications (odds ratio =21.37; p=0.024) and fast growth (odds ratio =22.70; p=0.021) were significant and independent factors associated with the risk of developing TC.
Conclusion: Microcalcifications and fast growth of the TN could therefore be used as predictive factors for the development of TC in patients with AUS/FLUS.

Keywords: atypia/follicular lesion of undetermined significance, thyroid nodules, thyroid cancer

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