ECE2015 Eposter Presentations Thyroid cancer (90 abstracts)
The risk of thyroid cancer (TC) in a thyroid nodule on the basis of a tertiary reference TC center experience
Aleksandra Blewaska 1 , Aleksandra Sygula 1 , Ewa Chmielik 2 , Ewa Stobiecka 2 , Ewa Zembala-Nozynska 2 , Agnieszka Czarniecka 3 , Aleksander Sacher 3 , Jolanta Krajewska 1 , Aleksandra Kukulska 1 & Barbara Jarzab 1
1Nuclear Medicine and Endocrine Oncology Department, M.Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland; 2Tumor Pathology Department, M.Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland; 3The Oncologic and Reconstructive Surgery Clinic, M.Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland.
A global TC risk in a single thyroid nodule is rather small and ranges between 1 and 11%. However, taking into consideration Bethesda System for Reporting Thyroid Cytopathology TC risk varies between distinct categories: 0–3, 5–15, 15–30, 60–75 and 97–99% for Bethesda class II–VI, respectively. However, these values may differ in a centre, specialized in TC. Therefore, the aim of this study was to evaluate the TC risk in patients referred to a tertiary reference TC centre.
Material: 282 thyroid nodules were involved into a retrospective analysis. Fine needle aspiration biopsy (FNAB) was performed in all cases and followed by surgery regardless of the results of FNAB. Next, histopathological findings were compared with FNAB results.
Results: According to FNAB 26.9% thyroid nodules were classified as benign (Bethesda II), 28.7% as malignant (Bethesda VI), while 23.8% as indeterminate (Bethesda III+IV+V). Among indeterminate nodules 3/67 were diagnosed as Bethesda III, 23/67 as follicular neoplasm (Bethesda IV), whereas 41/67 were suspicious for malignancy (Bethesda V). For 20.6% remaining tumours the FNAB result was nondiagnostic (Bethesda I). TC was diagnosed by histopathological examination in 171 tumours (60.6%), among them in 21/76, 39/67, 81/81 and 30/58 preoperatively classified as benign indeterminate, malignant and nondiagnostic, respectively. 96 nodules were benign in histopathology, while for 15 others no data were available. Finally, the risk of TC evaluated on the basis of aforementioned data was 27.6% for benign nodules, 39.1% for follicular neoplasm, 70.7% for nodules suspicious for malignancy and 100% when tumour were classified as malignant. Surprisingly, TC was confirmed after surgery in 51.7% with nondiagnostic FNAB.
Conclusions: The risk of TC in thyroid nodules referred to specialised thyroid cancer center is substantially higher than in routine practice. Thus, more careful procedures, including molecular markers are necessary to state a proper diagnosis and start the treatment on time.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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