Ann Surg Treat Res.  2016 Apr;90(4):201-206. 10.4174/astr.2016.90.4.201.

Clinicopathological factors increased the risk of malignancy in thyroid nodules with atypical or follicular lesions of undetermined significance (AUS/FLUS) risk factor of malignancy in thyroid nodule with AUS/FLUS

• Hong IK
• Kim JH
• Cho YU
• Park SY
• Kim SJ

• KMID: 2160949
• DOI: http://doi.org/10.4174/astr.2016.90.4.201

Abstract

PURPOSE
Ultrasound-guided fine needle aspiration (US-FNA) in thyroid nodules is presently most commonly used to identify whether these nodules are benign or malignant. However, atypical or follicular lesions of undetermined significance (AUS/FLUS), as categorized in the Bethesda System for reporting the results of FNA, cannot be classified as benign or malignant. Therefore, several clinical factors should be considered to assess the risk of malignancy in patients with AUS/FLUS. The purpose of the present study was to determine which clinical factor increased the risk of malignancy in patients with AUS/FLUS.
METHODS
A retrospective study was done on 129 patients with fine needle aspiration categorized as AUS/FLUS from January 2011 through April 2015. Univariate and multivariate analyses were performed to assess the independent effect of risk factors such as age, sex, size of nodule, atypical descriptors, and ultrasonography criteria for malignancy.
RESULTS
We identified that the presence of spiculated margin (odds ratio [OR], 5.655; 95% confidence interval [CI], 2.114-15.131; P = 0.001), nuclear grooving (OR, 3.697; 95% CI, 1.409-9.701; P = 0.008), irregular nuclei (OR, 3.903; 95% CI, 1.442-10.560; P = 0.001) were shown to be significantly related to malignancy on univariate and multivariate analyses.
CONCLUSION
We recommend that surgical resection of thyroid nodules be considered in patients with AUS/FLUS showing the histologic findings such as nuclear grooving, irregular nuclei along with spiculated margin of ultrasonographic finding.

Keyword

Atypical; Malignant; Thyroid nodule; Fine needle aspiration

MeSH Terms

Biopsy, Fine-Needle
Humans
Multivariate Analysis
Retrospective Studies
Risk Factors*
Subject Headings
Thyroid Gland*
Thyroid Nodule*
Ultrasonography

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