Liu Ruifeng, Gao Luying, Xia Yu, Li Xiaoyi, Liao Quan, Jiang Ying, Zhang Qing, Chen Cheng, Zhang Li, Liang Zhiyong, Jiang Yuxin
Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Gland Surg. 2021 Jan;10(1):307-318. doi: 10.21037/gs-20-612.
The terminology "non-invasive follicular thyroid neoplasm with papillary-like nuclear features" (NIFTP) was introduced to reduce overtreatment of thyroid carcinomas with indolent behavior. However, limited literature discussed the sonographic features of the entity in depth. The objective of this study is to summarize sonographic subtypes of NIFTP for precise diagnosis.
From January 2017 to June 2020, 13,531 consecutive patients underwent surgery for thyroid nodules were reviewed; 30 patients (0.22%) with 30 NIFTP were eligible for this retrospective observational study. We evaluated ultrasound features of all the lesions and distributed them into 3 major types of ultrasound appearance using pattern recognition. Systemic literature review concerning ultrasonography of NIFTP was also performed.
At sonography, all the NIFTP lesions were classified into three types: 19 (63.3%) were categorized into type A-oval and solid nodule without other high-suspicion features, 7 (23.3%) into type B-partially cystic mass without high-suspicion features, 4 (13.3%) into type C-hypoechoic solid nodule with high-suspicion features including irregular margins, microcalcifications, taller-than-wide shape.
Three ultrasound patterns were proposed by us for ultrasound-cytopathology correlation analysis.
“具有乳头样核特征的非侵袭性滤泡性甲状腺肿瘤”(NIFTP)这一术语被引入以减少对惰性甲状腺癌的过度治疗。然而,仅有有限的文献深入讨论了该实体的超声特征。本研究的目的是总结NIFTP的超声亚型以实现精准诊断。
回顾2017年1月至2020年6月期间连续接受甲状腺结节手术的13531例患者;30例(0.22%)患有30个NIFTP的患者符合本回顾性观察研究的条件。我们评估了所有病变的超声特征,并使用模式识别将它们分为3种主要的超声表现类型。还进行了关于NIFTP超声检查的系统文献综述。
在超声检查中,所有NIFTP病变被分为三种类型:19个(63.3%)被归类为A型——椭圆形实性结节,无其他高度可疑特征;7个(23.3%)被归类为B型——部分囊性肿物,无高度可疑特征;4个(13.3%)被归类为C型——低回声实性结节,具有包括边缘不规则、微钙化、纵横比大于1等高度可疑特征。
我们提出了三种超声模式用于超声-细胞病理学相关性分析。