Thyroid Cancers with BenignLooking Sonographic Fe

Authors: Dong Yeob Shin Young Ki Lee Kwang Joon Kim Kyeong Hye Park Sena Hwang Se Hee Park EunKyung Kim Hyeong Ju Kwon Eun Jig Lee

Publish Date: 2014/09/03

Volume: 25, Issue: 4, Pages: 378-384

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Abstract

A decision to perform fine needle aspiration FNA on thyroid nodules mainly depends on sonographic features We investigated if lymph node metastasis LNM risk differed by tumor size of thyroid cancers without suspicious sonographic features Three hundred sixty patients with thyroid cancers with benign looking sonographic features were grouped by nodule size on ultrasonography US ≤ or 1 cm The clinicopathologic parameters were compared between the groups A multivariate analysis was performed to discover the independent factors predicting the presence of LNM The nodules greater than 10 mm on US n = 157 demonstrated a larger tumor size on histology 179 ± 145 vs 56 ± 24 mm P  0001 a lower frequency of classical papillary thyroid carcinoma PTC 586 vs 872  P  0001 and a higher frequency of follicular variant PTC and follicular thyroid carcinoma 197 and 178  vs 94 and 15  respectively P  001 In subgroup analysis of 269 patients with classical PTC the larger nodule size on US was associated with a higher prevalence of LNM 283 vs 147  P = 0007 A multivariate analysis revealed that classical PTC extrathyroidal extension and the US nodule size 10 mm were independent predictive factors of LNM after adjusting for age sex TSH level and multifocality Thyroid cancers larger than 10 mm with benign US features are more likely to be nonclassical PTC than those with smaller diameters The larger ones also have an increased risk of LNM in classical PTC These cases require a more aggressive approach to FNA

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