Bethesda Categorization of Thyroid Nodule Cytology and Prediction of Thyroid Cancer Type and Prognosis
| العنوان: | Bethesda Categorization of Thyroid Nodule Cytology and Prediction of Thyroid Cancer Type and Prognosis |
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| المؤلفون: | Edmund S. Cibas, Trevor E. Angell, Daniel T. Ruan, Norra Kwong, Nancy L. Cho, P. Reed Larsen, Jeffrey F. Krane, Justine A. Barletta, Xiaoyun Liu, Marco Medici, Francis D. Moore, Matthew A. Nehs, Atul A. Gawande, Tao Yang, Matthew I. Kim, Ellen Marqusee, Erik K. Alexander |
| المساهمون: | Internal Medicine |
| المصدر: | Thyroid, 26(2), 256-261. Mary Ann Liebert Inc. |
| بيانات النشر: | Mary Ann Liebert Inc., 2016. |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | Oncology, Adult, Male, Risk, medicine.medical_specialty, Pathology, Databases, Factual, Lymphovascular invasion, Endocrinology, Diabetes and Metabolism, Cytodiagnosis, Biopsy, Fine-Needle, 030209 endocrinology & metabolism, Malignancy, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, SDG 3 - Good Health and Well-being, Cytology, Internal medicine, Carcinoma, medicine, Atypia, Humans, Longitudinal Studies, Prospective Studies, Thyroid Neoplasms, Thyroid Nodule, Neoplasm Metastasis, Thyroid cancer, Ultrasonography, business.industry, Thyroid, Thyroid Cancer and Nodules, Middle Aged, medicine.disease, Prognosis, Bethesda system for reporting thyroid cytopathology, Carcinoma, Papillary, medicine.anatomical_structure, Thyroid Cancer, Papillary, 030220 oncology & carcinogenesis, Lymphatic Metastasis, Female, Neoplasm Recurrence, Local, business |
| الوصف: | Since its inception, the Bethesda System for Reporting Thyroid Cytopathology (TBS) has been widely adopted. Each category conveys a risk of malignancy and recommended next steps, though it is unclear if each category also predicts the type and extent of malignancy. If so, this would greatly expand the utility of the TBS by providing prognostic information in addition to baseline cancer risk.All patients prospectively enrolled into the authors' thyroid nodule database from 1995 to 2013 with histologically proven malignancy were analyzed. The primary ultrasound-guided fine-needle aspiration cytology (AUS, atypia of unknown significance; FN, follicular neoplasm; SUSP, suspicious; M, malignant) was correlated with the type of thyroid cancer and histological features known to impact prognosis and recurrence, including lymph node metastasis (LNM), lymphovascular invasion, and extrathyroidal extension (ETE). Primary cytology was separately correlated with higher risk malignancy.A total of 1291 malignancies were identified, with primary cytology AUS in 130 cases, FN in 241 cases, SUSP in 411 cases, and M in 509 cases. AUS, SUSP, and M cytology were progressively associated with an increasing risk of high-risk disease (p 0.001), LNM (p 0.001), ETE (p 0.001), and margin positivity (p 0.001). Notably, 71% of malignancies with AUS cytology were follicular variants of papillary thyroid cancer compared with 63% with SUSP cytology and only 20% with M cytology. In contrast, high-risk malignancies were diagnosed in only 4% with AUS cytology, but 9% and 27% with SUSP and M cytology, respectively. FN conveyed a significantly increased risk of follicular thyroid carcinoma compared with all other types (28% vs. 2%; p 0.001). A composite endpoint of recurrence, distant metastases, and death similarly increased as cytology progressed from AUS to SUSP to M (p 0.001).In addition to predicting cancer prevalence, the TBS also imparts important prognostic information about cancer type, variant, and risk of recurrence. These data extend the utility of TBS classification by fostering an improved understanding of the risk posed by any confirmed malignancy. |
| تدمد: | 1557-9077 1050-7256 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1ec7ee5db619cc748bdee37ddf962c47Test https://doi.org/10.1089/thy.2015.0376Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....1ec7ee5db619cc748bdee37ddf962c47 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15579077 10507256 |
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