Clinical and ultrasonographic findings affecting nondiagnostic results upon the second fine needle aspiration for thyroid nodules

Yoon Seong Choi, Soon Won Hong, jinyoung kwak, Hee Jung Moon, Eunkyung Kim

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background. The purpose of this study was to investigate the clinical and ultrasonographic (US) findings affecting the nondiagnostic cytology and malignancy rate in thyroid nodules with nondiagnostic cytology upon a second ultrasound- guided fine needle aspiration (US-FNA). Materials and Methods. A total of 1124 nodules in 1081 patients (M:F = 111:970; mean age, 48.5 years) with 2 or more US-FNAs were included. Clinical and US features were compared between the nodules with nondiagnostic results and diagnostic results from their second FNA using univariate and multivariate analyses. The malignancy rate was analyzed in terms of nondiagnostic cytology. Results. Among 458 nondiagnostic results of the initial FNA, 94 nodules (20.5%) still had nondiagnostic results on the second FNA. Having cystic portion >50% (odds ratio [OR] = 2.845, P = .0001), nondiagnostic cytology of the first FNA (OR = 2.813, P<.0001), a nodule size ≥5 mm (OR = 1.742, P = .0331), or hypoechogenicity (OR = 1.512, P = .0404) were factors significantly affecting the incidence of nondiagnostic results in the second US-FNA based on multivariate analysis. The malignancy rate was 11.4% in the nodules with nondiagnostic results in the first FNA and 3.2% in the nodules with serial nondiagnostic results in both the first and second FNAs. Conclusions. The high probability of nondiagnostic results from a second FNA should be considered if a nodule shows cystic portion greater than 50%, nondiagnostic cytology on the first FNA, a nodule size ≤5 mm, or hypoechogenicity. The malignancy rate of thyroid nodules with 2 consecutive nondiagnostic results was 3.2%.

Original languageEnglish
Pages (from-to)2304-2309
Number of pages6
JournalAnnals of Surgical Oncology
Volume19
Issue number7
DOIs
Publication statusPublished - 2012 Jul 1

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Thyroid Nodule
Fine Needle Biopsy
Cell Biology
Odds Ratio
Neoplasms
Multivariate Analysis
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

@article{795a74cdda3344b5aaf4f1811daad593,
title = "Clinical and ultrasonographic findings affecting nondiagnostic results upon the second fine needle aspiration for thyroid nodules",
abstract = "Background. The purpose of this study was to investigate the clinical and ultrasonographic (US) findings affecting the nondiagnostic cytology and malignancy rate in thyroid nodules with nondiagnostic cytology upon a second ultrasound- guided fine needle aspiration (US-FNA). Materials and Methods. A total of 1124 nodules in 1081 patients (M:F = 111:970; mean age, 48.5 years) with 2 or more US-FNAs were included. Clinical and US features were compared between the nodules with nondiagnostic results and diagnostic results from their second FNA using univariate and multivariate analyses. The malignancy rate was analyzed in terms of nondiagnostic cytology. Results. Among 458 nondiagnostic results of the initial FNA, 94 nodules (20.5{\%}) still had nondiagnostic results on the second FNA. Having cystic portion >50{\%} (odds ratio [OR] = 2.845, P = .0001), nondiagnostic cytology of the first FNA (OR = 2.813, P<.0001), a nodule size ≥5 mm (OR = 1.742, P = .0331), or hypoechogenicity (OR = 1.512, P = .0404) were factors significantly affecting the incidence of nondiagnostic results in the second US-FNA based on multivariate analysis. The malignancy rate was 11.4{\%} in the nodules with nondiagnostic results in the first FNA and 3.2{\%} in the nodules with serial nondiagnostic results in both the first and second FNAs. Conclusions. The high probability of nondiagnostic results from a second FNA should be considered if a nodule shows cystic portion greater than 50{\%}, nondiagnostic cytology on the first FNA, a nodule size ≤5 mm, or hypoechogenicity. The malignancy rate of thyroid nodules with 2 consecutive nondiagnostic results was 3.2{\%}.",
author = "Choi, {Yoon Seong} and Hong, {Soon Won} and jinyoung kwak and Moon, {Hee Jung} and Eunkyung Kim",
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Clinical and ultrasonographic findings affecting nondiagnostic results upon the second fine needle aspiration for thyroid nodules. / Choi, Yoon Seong; Hong, Soon Won; kwak, jinyoung; Moon, Hee Jung; Kim, Eunkyung.

In: Annals of Surgical Oncology, Vol. 19, No. 7, 01.07.2012, p. 2304-2309.

Research output: Contribution to journalArticle

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T1 - Clinical and ultrasonographic findings affecting nondiagnostic results upon the second fine needle aspiration for thyroid nodules

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N2 - Background. The purpose of this study was to investigate the clinical and ultrasonographic (US) findings affecting the nondiagnostic cytology and malignancy rate in thyroid nodules with nondiagnostic cytology upon a second ultrasound- guided fine needle aspiration (US-FNA). Materials and Methods. A total of 1124 nodules in 1081 patients (M:F = 111:970; mean age, 48.5 years) with 2 or more US-FNAs were included. Clinical and US features were compared between the nodules with nondiagnostic results and diagnostic results from their second FNA using univariate and multivariate analyses. The malignancy rate was analyzed in terms of nondiagnostic cytology. Results. Among 458 nondiagnostic results of the initial FNA, 94 nodules (20.5%) still had nondiagnostic results on the second FNA. Having cystic portion >50% (odds ratio [OR] = 2.845, P = .0001), nondiagnostic cytology of the first FNA (OR = 2.813, P<.0001), a nodule size ≥5 mm (OR = 1.742, P = .0331), or hypoechogenicity (OR = 1.512, P = .0404) were factors significantly affecting the incidence of nondiagnostic results in the second US-FNA based on multivariate analysis. The malignancy rate was 11.4% in the nodules with nondiagnostic results in the first FNA and 3.2% in the nodules with serial nondiagnostic results in both the first and second FNAs. Conclusions. The high probability of nondiagnostic results from a second FNA should be considered if a nodule shows cystic portion greater than 50%, nondiagnostic cytology on the first FNA, a nodule size ≤5 mm, or hypoechogenicity. The malignancy rate of thyroid nodules with 2 consecutive nondiagnostic results was 3.2%.

AB - Background. The purpose of this study was to investigate the clinical and ultrasonographic (US) findings affecting the nondiagnostic cytology and malignancy rate in thyroid nodules with nondiagnostic cytology upon a second ultrasound- guided fine needle aspiration (US-FNA). Materials and Methods. A total of 1124 nodules in 1081 patients (M:F = 111:970; mean age, 48.5 years) with 2 or more US-FNAs were included. Clinical and US features were compared between the nodules with nondiagnostic results and diagnostic results from their second FNA using univariate and multivariate analyses. The malignancy rate was analyzed in terms of nondiagnostic cytology. Results. Among 458 nondiagnostic results of the initial FNA, 94 nodules (20.5%) still had nondiagnostic results on the second FNA. Having cystic portion >50% (odds ratio [OR] = 2.845, P = .0001), nondiagnostic cytology of the first FNA (OR = 2.813, P<.0001), a nodule size ≥5 mm (OR = 1.742, P = .0331), or hypoechogenicity (OR = 1.512, P = .0404) were factors significantly affecting the incidence of nondiagnostic results in the second US-FNA based on multivariate analysis. The malignancy rate was 11.4% in the nodules with nondiagnostic results in the first FNA and 3.2% in the nodules with serial nondiagnostic results in both the first and second FNAs. Conclusions. The high probability of nondiagnostic results from a second FNA should be considered if a nodule shows cystic portion greater than 50%, nondiagnostic cytology on the first FNA, a nodule size ≤5 mm, or hypoechogenicity. The malignancy rate of thyroid nodules with 2 consecutive nondiagnostic results was 3.2%.

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