A proposal of a new clinical, ultrasonographic and cytological scoring system for thyroid nodules: the

F. Ianni; C. Rota; P. Campanella; Rosa A. De; F. Gallo; Donna V. Di; P. Locantore; V. Luotto; M. Nestola; S. Corsello; A. Pontecorvi

P1796

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Endocrine Abstracts (2012) 29 P1796

ICEECE2012 Poster Presentations Thyroid cancer (108 abstracts)

A proposal of a new clinical, ultrasonographic and cytological scoring system for thyroid nodules: the ‘cut’ score

F. Ianni , C. Rota , P. Campanella , A. De Rosa , F. Gallo , V. Di Donna , P. Locantore , V. Luotto , M. Nestola , S. Corsello & A. Pontecorvi

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Università Cattolica del Sacro Cuore, Rome, Italy.

Aim: To develop a cost-effective instrument to evaluate the preoperative malignancy risk of thyroid nodules (TNs).

Patients&Methods: A meta-analysis of the clinical (C) and ultrasonographic (U) features associated with an increased risk of malignancy was conducted searching in the PubMed database. For each of them we computed the odds ratio and we consequently assigned a score. The resulted C+U score along with the 5-tiered score of fine-needle aspiration (FNA) result (T=1–5) designed the CUT score of the TN.

Moreover we enrolled 673 consecutive patients (514W/159M) with 689 TNs, we submitted them to clinical evaluation, ultrasonography and US-guided FNA. Hence we applied the CUT score and we correlated it with the histopathological diagnosis of the 79 TNs that underwent surgery.

Results: Features associated with a higher risk of malignancy resulted: male sex, family history of thyroid cancer, single nodule, size >4 cm, taller-than-wide shape, solid structure, hypoechogenicity, irregular margins, absent halo, microcalcifications and intranodular vascularization. A score was assigned to each of them.

Out of the 35 TNs with histopathological diagnosis of benign nodule, the average C+U score was 3.7 for the 3 TIR1 TNs, 2.5 for the 16 TIR2 TNs, 3.7 for the 11 TIR3 TNs and 4.1 for the 5 TIR4 TNs. Nevertheless out of the 44 TNs with histopathological diagnosis of malignancy, the average C+U score was 5.7 for the 8 TIR3 TNs, 7.6 for the 10 TIR4 TNs and 7.7 for the 26 TIR5 TNs. Sensitivity and specificity of the C+U score were respectively 96 and 56% with a cut-off of 3.5 and 67 and 94% with a cut-off of 6.5.

Conclusion: The CUT score can be a useful and cost-effective instrument in the preoperative management of TNs, especially for those with indeterminate or repetitively non-diagnostic FNA.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.