The predictors of malignancy in thyroid nodules with atypia of undetermined significance or follicular lesions of undetermined significance

Şimşek A., Kutlutürk K.

Annals of Medical Research, vol.27, no.9, pp.2478-2483, 2020 (Peer-Reviewed Journal)

  • Publication Type: Article / Article
  • Volume: 27 Issue: 9
  • Publication Date: 2020
  • Doi Number: 10.5455/annalsmedres.2020.03.198
  • Journal Name: Annals of Medical Research
  • Journal Indexes: TR DİZİN (ULAKBİM)
  • Page Numbers: pp.2478-2483


Abstract Aim: This study aimed to evaluate clinical, radiological and laboratory (neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios, and mean platelet value) features that may better define the rate of malignancy in order to contribute to the management of thyroid nodules with AUS/FLUS. Material and Methods: The data of patients with histologic findings of AUS/FLUS on FNA, who underwent surgery at General Surgery Department in a tertiary care hospital between January 2012 and December 2019, were reviewed retrospectively. The patients with any other malign and/or inflammatory diseases and continued on corticosteroid therapy and/or chemotherapy were excluded. Results: The current study included 60 patients (73.3% women), who underwent surgery for 62 thyroid nodules classified as AUS/ FLUS. The specimen pathology revealed a thyroid malignancy in 16 patients, including 10 patients with papillary cancer, 5 patients with micro-papillary thyroid cancer, 1 patient with minimally invasive follicular carcinoma. Ten patients had follicular adenoma. The remaining 35 patients (37 nodules) had nodular colloidal hyperplasia and/or chronic lymphocytic thyroiditis. The rates of malignancy (ROM) and neoplasia (RON) were 25.8% and 40.3%, respectively. Nearly half of the cases (41.9%) had chronic lymphocytic thyroiditis. The malignancy rate in cases with chronic lymphocytic thyroiditis was 26.9%, which was similar in cases without (25%). In multivariate analysis, only microcalcifications were found to be positively associated with malignancy (p: 0.1; [OR] 5.185; CI95% 1.4-19.18). Conclusion: Chronic lymphocytic thyroiditis may lead to overestimation of AUS/FLUS results. It was not associated with malignancy in thyroid nodules with AUS/FLUS. Inflammatory values, such as NLR, PLR and MPV, were not useful markers of malignancy. Among all variables only US findings (microc