Nodules ≤1 cm with Highly Suspicious Ultrasound Features and Papillary Microcarcinoma of the Thyroid: Is Fine-Needle Aspiration Cytology Necessary before Deciding on Active Surveillance?

Rosário, Pedro Weslley

doi:10.1159/000486671

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…Among these patients, 54.2% only had a clear cut, benign (Bethesda II) or malignant (Bethesda VI), cytological result (Table 2). While some authors advocate that FNAB should precede the decision of active surveillance of nodules ≤ 10 mm (11), our study shows that FNAB is frequently caught in default in small nodules. This is consistent with previous reports showing rates as high as 60% of indeterminate cytological diagnosis (Bethesda III, IV, V) for malignant thyroid nodules under 5 mm and 27% for those between 5 and 10 mm have been reported (12).…”

Section: Discussioncontrasting

confidence: 61%

“…Consequently, there is a contradiction with the way AS is usually undertaken and reported, as most patients with such sub-centimeter nodules have been submitted to FNAB. Indeed, some authors such as P W Rosario et al (11) consider that FNAB should precede the decision of AS of nodules ≤ 10 mm, to avoid repeating US if benign, to prevent the psychological stress of having a presumptive diagnosis of 'cancer' or of a 'nodule with highly suspicious features', or to detect rare cytological variants of cancer that are not candidates for active surveillance. However, rates of non-diagnostic and indeterminate cytological results in sub-centimeter nodules can be as high as 35.6 and 60%, respectively (12,13,14).…”

Section: Introductionmentioning

confidence: 99%

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Outcomes of active surveillance of EU-TIRADS 5 thyroid nodules

Rozenbaum¹,

Buffet²,

Bigorgne

et al. 2021

European Journal of Endocrinology

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Objective: Active surveillance of cytologically proven microcarcinomas has been shown as a safe procedure. However, fine needle aspiration biopsy (FNAB) is not recommended by European Thyroid Association (ETA) and American Thyroid Association (ATA) guidelines for highly suspicious nodules ≤ 10mm. The aim of the study was to assess the outcomes of active surveillance of EU-TIRADS 5 nodules ≤ 10 mm not initially submitted to FNAB. Patients and Methods: 80 patients with at least one EU-TIRADS 5 nodule ≤ 10 mm and no suspicious lymph nodes, accepting active surveillance, were included. Results: Mean baseline diameter and volume were 5.4 mm (± 2.0) and 64.4 mm3 (± 33.5), respectively. After a median follow-up of 36.1 months, a volumetric increase ≥ 50% occurred in 28 patients (35.0%) and a suspicious lymph node in 3 patients (3.8%). 24 patients underwent an FNAB (30.0%) after at least a one year follow-up, of which 45.8% were malignant, 8.3% benign, 33.3% undetermined and 8.3% nondiagnostic. Sixteen patients (20.0%) underwent conversion surgery after a median follow-up of 57.2 months, confirming the diagnosis of papillary carcinoma in 15/16 cases (not described in 1 histology report), all in remission at 6-12 months postoperative follow-up. Conclusion: Applying ETA and ATA guidelines to avoid FNA of EU-TIRADS 5 sub-centimeter nodules and proceeding to active surveillance of such nodules in selected patients is a safe procedure. Thus, US-FNAB could be postponed until the nodule shows signs of progression or a suspicious lymph node appears, with no added risk for the patient.

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Section: Discussioncontrasting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Outcomes of active surveillance of EU-TIRADS 5 thyroid nodules

Rozenbaum¹,

Buffet²,

Bigorgne

et al. 2021

European Journal of Endocrinology

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“…Subsequently, the high local recurrence rate further results in much worse prognosis [8, 16]. Some possible malignant behaviors (e.g., age of patients >45 years, chancroid size >5 mm, multifocal carcinoma, extrathyroid extension, vascular invasion, and node involvement) also have been identified by clinical and histological aspects [17]. With the continuous progress of molecular biology, the development of reliable molecular markers has greatly promoted the diagnosis and prognosis of various diseases [18].…”

Section: Introductionmentioning

confidence: 99%

Transcriptome Analysis Identified 2 New lncRNAs Associated with the Metastasis of Papillary Thyroid Carcinoma

Arikin

Chen

et al. 2021

ORL

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Introduction: Papillary thyroid microcarcinoma (PTMC) is a specific subgroup of papillary thyroid carcinoma and defined with the dimension ≤1 cm by the WHO. Although it shows a relatively high 10-year livability, the metastasis of PTMC into other tissues and organs seriously affects the daily life of patients with relatively high mortality. Therefore, the genetic basis for the metastasis of PTMC needs to be explored for effective therapeutic targets. Here, we conducted a series of comparative analysis of the transcriptional expression profile between PTMC patients with and without lymph node metastasis. Methods: Gene expression profile and gene function were analyzed using RNA extracted from pathological tissues of 12 patients with PTMC, and the core biomarkers closely related to its metastasis were identified. Results: Our results showed that 7,507 genes and 42 RNAs showed remarkably different expression patterns. More sophisticated analysis showed that the high expression of 2 lncRNAs (T077499 and T004533) resulted in the metastasis of PTMC, which suggests that the expression pattern of the 2 lncRNAs may act as a potential biomarker for pathogenesis and prognosis of PTMC metastasis. Conclusion: Our findings preliminarily reveal the molecular mechanisms for PTMC metastasis, which will provide vital reference for subsequent studies about the genetic basis and molecular targeted therapy for PTMC metastasis.

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