Lee Yoo Jin, Kim Jee Young, Na Dong Gyu, Kim Ji-Hoon, Oh Minkyung, Kim Dae Bong, Yoon Ra Gyoung, Kim Seul Kee, Bak Seongjun
Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Ultrasonography. 2022 Oct;41(4):670-677. doi: 10.14366/usg.22059. Epub 2022 Jun 10.
The aim of this multicenter study was to investigate the malignancy risk of minimally cystic thyroid nodules (MCTNs) using cyto-histopathologic diagnoses as the reference standard.
From June 2015 to September 2015, 5,601 thyroid nodules (≥1 cm) from 4,989 consecutive patients who underwent thyroid ultrasonography (US) at 26 institutions were retrospectively analyzed. Each thyroid nodule was categorized according to its cystic proportion: purely solid, minimally cystic (≤10%), and partially cystic (>10%). The malignancy risk of MCTNs was compared with those of purely solid nodules and partially cystic thyroid nodules (PCTNs). The malignancy risk of MCTNs was assessed according to echogenicity and the presence of suspicious US features.
The prevalence of MCTNs was 22.5%. The overall malignancy risk of MCTNs was 8.8%, which was significantly lower than that of purely solid nodules (29.5%) (P<0.001), and slightly higher than that of PCTNs (6.2%) (P=0.013). The risk of malignancy associated with MCTNs was similar to that of PCTNs regardless of echogenicity or the presence of suspicious US features (all P>0.05). MCTNs were associated with a higher risk of malignancy in hypoechoic nodules than in isohyperechoic nodules and in nodules with suspicious US features than in those without suspicious US features (all P<0.001).
The malignancy risk of MCTNs was significantly lower than that of purely solid nodules. MCTNs could be categorized as PCTNs rather than as solid nodules to increase the accuracy of the risk stratification system for thyroid nodules.
本多中心研究旨在以细胞-组织病理学诊断为参考标准，调查微小囊性甲状腺结节（MCTN）的恶性风险。
回顾性分析2015年6月至2015年9月期间在26家机构接受甲状腺超声检查（US）的4989例连续患者的5601个甲状腺结节（≥1 cm）。每个甲状腺结节根据其囊性比例进行分类：纯实性、微小囊性（≤10%）和部分囊性（>10%）。将MCTN的恶性风险与纯实性结节和部分囊性甲状腺结节（PCTN）的恶性风险进行比较。根据回声性和可疑超声特征的存在评估MCTN的恶性风险。
MCTN的患病率为22.5%。MCTN的总体恶性风险为8.8%，显著低于纯实性结节（29.5%）（P<0.001），略高于PCTN（6.2%）（P=0.013）。无论回声性或可疑超声特征的存在如何，MCTN的恶性风险与PCTN相似（所有P>0.05）。与等/高回声结节相比，低回声结节中的MCTN与更高的恶性风险相关；与无可疑超声特征的结节相比，有可疑超声特征的结节中的MCTN与更高的恶性风险相关（所有P<0.001）。
MCTN的恶性风险显著低于纯实性结节。MCTN可归类为PCTN而非实性结节，以提高甲状腺结节风险分层系统的准确性。
