Cargando…

Usability of EU-TIRADS in the Diagnostics of Hürthle Cell Thyroid Nodules with Equivocal Cytology

The aim of this study was to compare the diagnostic effectiveness of EU-TIRADS in two groups of nodules with equivocal cytology (categories III-V of Bethesda system), with and without Hürthle cells (HC and non-HC). The study included 162 HC and 378 non-HC nodules with determined histopathological di...

Descripción completa

Detalles Bibliográficos
Autores principales: Słowińska-Klencka, Dorota, Wysocka-Konieczna, Kamila, Klencki, Mariusz, Popowicz, Bożena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7690849/
https://www.ncbi.nlm.nih.gov/pubmed/33114341
http://dx.doi.org/10.3390/jcm9113410
_version_ 1783614162417483776
author Słowińska-Klencka, Dorota
Wysocka-Konieczna, Kamila
Klencki, Mariusz
Popowicz, Bożena
author_facet Słowińska-Klencka, Dorota
Wysocka-Konieczna, Kamila
Klencki, Mariusz
Popowicz, Bożena
author_sort Słowińska-Klencka, Dorota
collection PubMed
description The aim of this study was to compare the diagnostic effectiveness of EU-TIRADS in two groups of nodules with equivocal cytology (categories III-V of Bethesda system), with and without Hürthle cells (HC and non-HC). The study included 162 HC and 378 non-HC nodules with determined histopathological diagnosis (17.9% and 15.6% cancers). In both groups calculated and expected risk of malignancy (RoM) for high, intermediate and benign risk categories of EU-TIRADS were concordant. RoM for low risk category was higher than expected in both groups, but especially in HC (HC: 13.9%, non-HC: 7.0%, expected: 2–4%). The majority of cancers in HC of that category were follicular thyroid carcinomas (FTC) and Hürthle cell thyroid carcinoma (HTC) (60.0% vs. non-HC: 16.7%). The diagnostic efficacy of EU-TIRADS was lower in HC (the area under the receiver operating characteristics curve (AUC): 0.621, sensitivity (SEN): 44.8%, specificity (SPC): 78.9% for high risk threshold) than in non-HC (AUC: 0.711, SEN: 61.0%, SPC: 77.7%). AUC was the highest for category V (AUC > 0.8, both groups) and the lowest for category IV (inefficient, both group). If intermediate risk category was interpreted as an indication for surgery, 25% of cancers from category III and 21.4% from category IV would not be treated in the HC group (0.0% and 7.4% from non-HC group, respectively). EU-TIRADS does not aid making clinical decisions in patients with cytologically equivocal HC nodules, particularly those classified into category IV of Bethesda System for Reporting Thyroid Cytopathology (BSRTC).
format Online
Article
Text
id pubmed-7690849
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-76908492020-11-27 Usability of EU-TIRADS in the Diagnostics of Hürthle Cell Thyroid Nodules with Equivocal Cytology Słowińska-Klencka, Dorota Wysocka-Konieczna, Kamila Klencki, Mariusz Popowicz, Bożena J Clin Med Article The aim of this study was to compare the diagnostic effectiveness of EU-TIRADS in two groups of nodules with equivocal cytology (categories III-V of Bethesda system), with and without Hürthle cells (HC and non-HC). The study included 162 HC and 378 non-HC nodules with determined histopathological diagnosis (17.9% and 15.6% cancers). In both groups calculated and expected risk of malignancy (RoM) for high, intermediate and benign risk categories of EU-TIRADS were concordant. RoM for low risk category was higher than expected in both groups, but especially in HC (HC: 13.9%, non-HC: 7.0%, expected: 2–4%). The majority of cancers in HC of that category were follicular thyroid carcinomas (FTC) and Hürthle cell thyroid carcinoma (HTC) (60.0% vs. non-HC: 16.7%). The diagnostic efficacy of EU-TIRADS was lower in HC (the area under the receiver operating characteristics curve (AUC): 0.621, sensitivity (SEN): 44.8%, specificity (SPC): 78.9% for high risk threshold) than in non-HC (AUC: 0.711, SEN: 61.0%, SPC: 77.7%). AUC was the highest for category V (AUC > 0.8, both groups) and the lowest for category IV (inefficient, both group). If intermediate risk category was interpreted as an indication for surgery, 25% of cancers from category III and 21.4% from category IV would not be treated in the HC group (0.0% and 7.4% from non-HC group, respectively). EU-TIRADS does not aid making clinical decisions in patients with cytologically equivocal HC nodules, particularly those classified into category IV of Bethesda System for Reporting Thyroid Cytopathology (BSRTC). MDPI 2020-10-24 /pmc/articles/PMC7690849/ /pubmed/33114341 http://dx.doi.org/10.3390/jcm9113410 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Słowińska-Klencka, Dorota
Wysocka-Konieczna, Kamila
Klencki, Mariusz
Popowicz, Bożena
Usability of EU-TIRADS in the Diagnostics of Hürthle Cell Thyroid Nodules with Equivocal Cytology
title Usability of EU-TIRADS in the Diagnostics of Hürthle Cell Thyroid Nodules with Equivocal Cytology
title_full Usability of EU-TIRADS in the Diagnostics of Hürthle Cell Thyroid Nodules with Equivocal Cytology
title_fullStr Usability of EU-TIRADS in the Diagnostics of Hürthle Cell Thyroid Nodules with Equivocal Cytology
title_full_unstemmed Usability of EU-TIRADS in the Diagnostics of Hürthle Cell Thyroid Nodules with Equivocal Cytology
title_short Usability of EU-TIRADS in the Diagnostics of Hürthle Cell Thyroid Nodules with Equivocal Cytology
title_sort usability of eu-tirads in the diagnostics of hürthle cell thyroid nodules with equivocal cytology
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7690849/
https://www.ncbi.nlm.nih.gov/pubmed/33114341
http://dx.doi.org/10.3390/jcm9113410
work_keys_str_mv AT słowinskaklenckadorota usabilityofeutiradsinthediagnosticsofhurthlecellthyroidnoduleswithequivocalcytology
AT wysockakoniecznakamila usabilityofeutiradsinthediagnosticsofhurthlecellthyroidnoduleswithequivocalcytology
AT klenckimariusz usabilityofeutiradsinthediagnosticsofhurthlecellthyroidnoduleswithequivocalcytology
AT popowiczbozena usabilityofeutiradsinthediagnosticsofhurthlecellthyroidnoduleswithequivocalcytology