دورية
Thyroid fineneedle aspiration with atypia of undetermined significance
| العنوان: | Thyroid fineneedle aspiration with atypia of undetermined significance |
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| المؤلفون: | Shi, Yan, Ding, Xin, Klein, Melissa, Sugrue, Chiara, Matano, Sandra, Edelman, Morris, Wasserman, Patricia |
| المصدر: | Cancer Cytopathology; October 2009, Vol. 117 Issue: 5 p298-304, 7p |
| مستخلص: | BACKGROUND:Atypia of undetermined significance is a controversial category in thyroid fineneedle aspiration FNA, not only for its questioned clinical utility, but also for its very existence as an expression of uncertainty. The current study was performed to investigate the potential impact of eliminating this category on the sensitivity and specificity for detecting thyroid neoplasms by FNA.METHODS:Forty cases originally diagnosed as atypia of undetermined significance with histologic followup were selected for the present study. These cases were reinterpreted blindly by 2 experienced reviewers, who eliminated atypia of undetermined significance as a diagnostic possibility and reclassified these cases as either benign, follicular neoplasm, suspicious for malignancy, or malignant. Twentysix cases of atypia of undetermined significance were randomly selected and reevaluated 6 months later to study intraobserver variation.RESULTS:After eliminating the atypia of undetermined significance category, the sensitivity for detecting papillary thyroid carcinoma PTC was reduced from 100 to 27 P .04. In those atypia of undetermined significance cases that were reclassified as benign, 37 had PTC. In those reclassified as follicular neoplasm or suspicious for malignancy, 38 were histologically proven to be benign lesions. Unanimous interobserver and intraobserver agreement was observed in only 60 of cases.CONCLUSIONS:Eliminating the diagnosis of atypia of undetermined significance substantially decreases the sensitivity of thyroid FNAs and increases both falsepositive and falsenegative rates. In addition, it increases interobserver and intraobserver variability. Therefore, the atypia of undetermined significance category should not be eliminated; but we advocate minimizing its use. Cancer Cancer Cytopathol 2009. © 2009 American Cancer Society. |
| قاعدة البيانات: | Supplemental Index |
Full Text Finder | تدمد: | 1934662X 19346638 |
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| DOI: | 10.1002/cncy.20039 |