Usability of EU-TIRADS in the Diagnostics of Hürthle Cell Thyroid Nodules with Equivocal Cytology
Abstract
:1. Introduction
2. Materials and Methods
2.1. Examined Patients
2.2. Microscopic Examination
2.3. Analysis of US Malignancy Features
2.4. Analyses, Statistical Evaluation
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Parameter | HC | Non-HC | p | ||||
---|---|---|---|---|---|---|---|
Number of nodules | 162 | 378 | |||||
Number of patients | 138 | 347 | |||||
Age—mean ± SD (years) | 56.3 ± 13.9 | 53.0 ± 13.9 | <0.05 | ||||
No/% of males | 10/7.2 | 42/12.1 | NS | ||||
Volume of nodules mean ± SD (cm3) | 6.41 ± 15.0 | 6.00 ±11.9 | NS | ||||
No/% of cancers | 29/17.9 | 59/15.6 | NS | ||||
No/% of PTCs among cancers | 13/44.8 | 44/74.6 | <0.01 | ||||
Other cancers (No/%) | FTC (4/13.8), HTC (11/37.9) MTC (1/3.4) | FTC (10/16.9), HTC (1/1.7), MTC (2/3.4), AC (1/1.7), ANG (1/1.7) | HTC: <0.0001 | ||||
category of BSRTC | |||||||
III | IV | V | III | IV | V | ||
No/% of cancers among nodules in each category of BSRTC/p | 8/15.1 | 14/14.4 | 7/58.3 | 27/9.8 | 5/7.1 | 27/84.4 | NS |
HC: <0.005: V vs. III & IV | non-HC: <0.0001: V vs. III & IV | ||||||
No/% of PTCs among cancers in each category of BSRTC/p | 3/37.5 | 4/28.6 | 6/85.7 | 17/63.0 | 2/40.0 | 25/92.6 | NS |
HC: <0.05 V vs. IV | non-HC: <0.05 V vs. III & IV |
Sonographic Feature * | HC Nodules | Non-HC Nodules | ||||||
---|---|---|---|---|---|---|---|---|
Ben. (133) No/% | Mal. (29) No/% | p | OR CI95% p | Ben. (319) No/% | Mal. (59) No/% | p | OR CI95% p | |
marked hypoechogenicity | 6/4.5 | 7/24.1 | <0.001 | 6.7 (2.1–21.9) 0.002 | 28/8.8 | 14/23.7 | <0.001 | 3.2 (1.6–6.6) 0.001 |
hypoechogenicity | 95/71.4 | 24/82.8 | NS | 1.9 (0.7–5.4) 0.216 | 223/69.9 | 49/83.1 | <0.05 | 2.1 (1.0–4.3) 0.004 |
solid echostructure | 121/91.0 | 25/86.2 | NS | 0.6 (0.2–2.1) 0.439 | 243/76.2 | 52/88.1 | <0.05 | 2.3 (1.0–5.3) 0.005 |
more solid than cystic echostructure | 131/98.5 | 28/96.5 | NS | 0.4 (0.1–4.9) 0.494 | 271/84.9 | 58/98.3 | <0.01 | 4.9 (0.7–37.1) <0.121 |
spongiform echostructure | 2/1.5 | 0/0/0 | NS | 0.0 (0.0–) 0.998 | 11/3.4 | 0/0.0 | NS | 0.0 (0.0–) 0.997 |
suspicious shape | 15/11.3 | 7/24.1 | NS | 2.5 (0.9–6.8) 0.074 | 34/10.7 | 11/18.6 | NS | 1.9 (0.9–4.0) 0.086 |
irregular margins | 3/2.3 | 5/17.2 | <0.001 | 9.0 (2.0–40.3) 0.004 | 14/14.4 | 18/30.5 | <0.0001 | 9.6 (4.4–20.7) <0.0001 |
microcalcifications | 5/3.8 | 5/17.2 | <0.01 | 5.3 (1.4–19.8) 0.013 | 12/3.8 | 9/15.3 | <0.0005 | 4.6 (1.8–11.5) 0.001 |
macrocalcifications | 3/2.3 | 3/10.3 | NS | 5.0 (1.0–26.2) 0.057 | 23/7.2 | 8/13,6 | NS | 2.0 (0.9–4.8) 0.108 |
rim calcifications | 3/2.3 | 2/6.9 | NS | 3.2 (0.5–20.1) 0.213 | 10/3,1 | 3/5,1 | NS | 1.4 (0.4–6.2) 0.454 |
pathologicalvascularization | 30/22.6 | 9/31.0 | NS | 1.5 (0.6–3.7) 0.3365 | 77/24.1 | 16/27.1 | NS | 1.2 (0.6–2.2) 0.626 |
Category of TIRADS | No/% of Nodules | No/% ben. nod | No/% mal. nod. | Calc. T-RoM | Expec. T-RoM | No/% of PTC | No/% of FTC | No/% of HTC | No/% of MTC | No/% of ATC | No/% of ANG |
---|---|---|---|---|---|---|---|---|---|---|---|
HC nodules | |||||||||||
benign | 2/1.2 | 2/1.5 | 0/0 | 0.0 | 0 | ||||||
low risk | 36/22.2 | 31/23.3 | 5/17.2 | 13.9 | 2–4 | 2/15.4 | 1/25.0 | 2/18.2 | |||
intermediate risk | 83/51.2 | 72/54.1 | 11/37.9 | 13.3 | 6–17 | 3/23.1 | 2/50.0 | 5/45.4 | 1/100.0 | ||
high risk | 41/25.3 | 28/21.1 | 13/44.8 | 31.7 | 26–87 | 8/61.5 | 1/25.0 | 4/36.4 | |||
non-HC nodules | |||||||||||
benign | 10/2.6 | 10/3.1 | 0/0 | 0.0 | 0 | ||||||
low risk | 86/22.8 | 80/25.1 | 6/10.2 | 7.0 | 2–4 | 5/11.4 | 1/10.0 | ||||
intermediate risk | 175/46.3 | 158/49.5 | 17/28.8 | 9.7 | 6–17 | 11/25.0 | 5/50.0 | 1/100.0 | |||
high risk | 107/28.3 | 71/22.3 | 36/61.0 | 33.6 | 26–87 | 28/63.6 | 4/40.0 | 2/100.0 | 1/100.0 | 1/100.0 |
Category of BSRTC | ||||||||
---|---|---|---|---|---|---|---|---|
All Categories | III | IV | V | |||||
HC | Non-HC | HC | Non-HC | HC | Non-HC | HC | Non-HC | |
AUC | 0.621 | 0.711 | 0.628 | 0.716 | 0.582 | 0.674 | 0.829 | 0.859 |
95% Cl | 0.502–0.739 | 0.638–0.784 | 0.396–0.860 | 0.616–0.816 | 0.404–0.760 | 0.463–0.884 | 0.591–1.0 | 0.726–0.992 |
p | <0.05 | <0.0001 | 0.280 | <0.0001 | 0.366 | 0.105 | 0.007 | <0.0001 |
EU-TIRADS threshold category: high risk (5) | ||||||||
SEN | 44.8 | 61.0 | 37.5 | 55.6 | 50.0 | 60.0 | 42.9 | 66.7 |
SPC | 78.9 | 77.7 | 88.9 | 80.3 | 72.3 | 66.2 | 100.0 | 100.0 |
ACC | 72.8 | 75.1 | 81.1 | 77.9 | 69.1 | 65.7 | 66.7 | 71.9 |
PPV | 31.7 | 33.6 | 37.5 | 23.4 | 23.3 | 12.0 | 100.0 | 100.0 |
NPV | 86.8 | 91.5 | 88.9 | 94.3 | 89.6 | 95.6 | 55.6 | 35.7 |
OR | 3.0 | 5.5 | 4.8 | 5.1 | 2.5 | 2.9 | - | - |
95% Cl | 1.3–7.1 | 3.0–9.8 | 0.9–26.4 | 2.2–11.6 | 0.8–8.3 | 0.5–18.9 | ||
p | 0.009 | < 0.0001 | 0.072 | 0.0001 | 0.103 | 0.257 | ||
EU-TIRADS threshold category:intermediate risk (4) | ||||||||
SEN | 82.8 | 89.8 | 75.0 | 92.6 | 78.6 | 100.0 | 100.0 | 85.2 |
SPC | 24.8 | 28.2 | 33.3 | 29.3 | 19.3 | 21.5 | 40.0 | 60.0 |
ACC | 35.2 | 37.8 | 39.6 | 35.5 | 27.8 | 27.1 | 75.0 | 81.3 |
PPV | 19.4 | 1.8 | 16.7 | 12.4 | 14.1 | 8.9 | 70.0 | 92.0 |
NPV | 86.8 | 93.8 | 88.2 | 97.3 | 84.2 | 100.0 | 100.0 | 42.9 |
OR | 1.6 | 3.5 | 1.5 | 5.2 | 0.9 | - | - | 8.6 |
95% Cl | 0.6–4.5 | 1.4–8.4 | 0.3–8.3 | 1.2–22.4 | 0.2–3.5 | 1.1–69.1 | ||
p | 0.386 | 0.005 | 0.643 | 0.028 | 0.851 | 0.042 |
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Słowińska-Klencka, D.; Wysocka-Konieczna, K.; Klencki, M.; Popowicz, B. Usability of EU-TIRADS in the Diagnostics of Hürthle Cell Thyroid Nodules with Equivocal Cytology. J. Clin. Med. 2020, 9, 3410. https://doi.org/10.3390/jcm9113410
Słowińska-Klencka D, Wysocka-Konieczna K, Klencki M, Popowicz B. Usability of EU-TIRADS in the Diagnostics of Hürthle Cell Thyroid Nodules with Equivocal Cytology. Journal of Clinical Medicine. 2020; 9(11):3410. https://doi.org/10.3390/jcm9113410
Chicago/Turabian StyleSłowińska-Klencka, Dorota, Kamila Wysocka-Konieczna, Mariusz Klencki, and Bożena Popowicz. 2020. "Usability of EU-TIRADS in the Diagnostics of Hürthle Cell Thyroid Nodules with Equivocal Cytology" Journal of Clinical Medicine 9, no. 11: 3410. https://doi.org/10.3390/jcm9113410