Department of Endocrinology and Metabolism, Faculty of Medicine, Education and Research Hospital, Karabük University, Karabük, Turkey.
Department of Endocrinology and Metabolism, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey.
Clin Endocrinol (Oxf). 2023 Nov;99(5):502-510. doi: 10.1111/cen.14965. Epub 2023 Sep 14.
The present article analyses pre-operative demographic, biochemical, sonographic and histopathological characteristics of low-risk thyroid neoplasms (LRTNs), with a focus on four subgroups, "well-differentiated carcinoma-not otherwise specified" (WDC-NOS), "non-invasive follicular thyroid neoplasm with papillary like nuclear features" (NIFTP), "well-differentiated tumours of uncertain malignant potential" (WDT-UMP) and "follicular tumour of uncertain malignant potential" (FT-UMP).
The study retrospectively analyzed the histopathology of 2453 malignant thyroids and the final analyses included 99 cases diagnosed with LRTNs. The demographic and clinical features, pre-operative thyroid function, ultrasonography results, cytopathology results, histopathology results and prognostic classifications were assessed.
The groups were similar demographic characteristics and the majority of clinical data, including comorbidities, thyroid function tests, thyroid cancer/neck radiotherapy history. NIFTPs represented 69.7% of all LRTNs. All (100%) WDT-UMPs had solitary nodules. Index nodule volume differed among the groups (p = .036), it was the lowest in WDC-NOS [0.68 (0.63-0.72 cc)] and highest in FT-UMP [12.6 (0.5-64 cc)]. Echogenicity findings were similar. Index nodule TIRADS demonstrated a significant difference (p = .021) but index nodule halo sign and BETHESDA scores were similar in all groups. The diameter, localisation and multicentric structure of LRTNs were again similar for all groups. Finally, prognostic scores suggested similar outcomes in all groups.
The majority of LRTNs were NIFTPs in our population and all WDT-UMPs were solitary lesions. Index nodule volume was the most essential discriminating sonographic finding but further research must be performed before discriminatory potential can be described.
本研究分析了低危甲状腺肿瘤(LRTN)的术前人口统计学、生化、超声和组织病理学特征,重点关注四个亚组:“非特指型分化良好癌(WDC-NOS)”、“具有滤泡型乳头状核特征的非侵袭性滤泡性甲状腺肿瘤(NIFTP)”、“具有不确定恶性潜能的分化良好肿瘤(WDT-UMP)”和“具有不确定恶性潜能的滤泡性肿瘤(FT-UMP)”。
本研究回顾性分析了 2453 例恶性甲状腺的组织病理学,最终分析包括 99 例诊断为 LRTN 的病例。评估了人口统计学和临床特征、术前甲状腺功能、超声结果、细胞学结果、组织病理学结果和预后分类。
各组具有相似的人口统计学特征和大多数临床数据,包括合并症、甲状腺功能检查、甲状腺癌/颈部放疗史。NIFTP 占所有 LRTN 的 69.7%。所有(100%)WDT-UMP 均为单发结节。各组间结节指数体积存在差异(p=0.036),WDC-NOS 组最低[0.68(0.63-0.72 cc)],FT-UMP 组最高[12.6(0.5-64 cc)]。回声特征相似。各组间 TIRADS 指数结节存在显著差异(p=0.021),但 halo 征和 BETHESDA 评分相似。LRTN 的直径、定位和多中心结构在所有组中再次相似。最后,预后评分提示所有组的结局相似。
在我们的人群中,大多数 LRTN 为 NIFTP,所有 WDT-UMP 均为单发病变。结节指数体积是最重要的鉴别性超声发现,但在描述其鉴别潜能之前,必须进行进一步研究。