Thyroid Cancers with Benign-Looking Sonographic Features Have Different Lymph Node Metastatic Risk and Histologic Subtypes According to Nodule Size

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

Research output: Contribution to journalArticle

2 Citations (Scopus)

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 (17.9 ± 14.5 vs. 5.6 ± 2.4 mm, P < 0.001), a lower frequency of classical papillary thyroid carcinoma (PTC) (58.6 vs. 87.2 %, P < 0.001), and a higher frequency of follicular variant PTC and follicular thyroid carcinoma (19.7 and 17.8 % vs. 9.4 and 1.5 %, respectively, P < 0.01). In subgroup analysis of 269 patients with classical PTC, the larger nodule size on US was associated with a higher prevalence of LNM (28.3 vs. 14.7 %, P = 0.007). 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.

Original languageEnglish
Pages (from-to)378-384
Number of pages7
JournalEndocrine Pathology
Volume25
Issue number4
DOIs
Publication statusPublished - 2014 Nov 21

Fingerprint

Thyroid Neoplasms
Lymph Nodes
Neoplasm Metastasis
Ultrasonography
Factor IX
Fine Needle Biopsy
Thyroid Nodule
Neoplasms
Histology
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Shin, Dong Yeob ; Lee, Young Ki ; Kim, Kwang Joon ; Park, Kyeong Hye ; Hwang, Sena ; Park, Se Hee ; Kim, Eun Kyung ; Kwon, Hyeong Ju ; Lee, Eun Jig. / Thyroid Cancers with Benign-Looking Sonographic Features Have Different Lymph Node Metastatic Risk and Histologic Subtypes According to Nodule Size. In: Endocrine Pathology. 2014 ; Vol. 25, No. 4. pp. 378-384.
@article{5e93b434bc844c75817b398e47c4e5f3,
title = "Thyroid Cancers with Benign-Looking Sonographic Features Have Different Lymph Node Metastatic Risk and Histologic Subtypes According to Nodule Size",
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 (17.9 ± 14.5 vs. 5.6 ± 2.4 mm, P < 0.001), a lower frequency of classical papillary thyroid carcinoma (PTC) (58.6 vs. 87.2 {\%}, P < 0.001), and a higher frequency of follicular variant PTC and follicular thyroid carcinoma (19.7 and 17.8 {\%} vs. 9.4 and 1.5 {\%}, respectively, P < 0.01). In subgroup analysis of 269 patients with classical PTC, the larger nodule size on US was associated with a higher prevalence of LNM (28.3 vs. 14.7 {\%}, P = 0.007). 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.",
author = "Shin, {Dong Yeob} and Lee, {Young Ki} and Kim, {Kwang Joon} and Park, {Kyeong Hye} and Sena Hwang and Park, {Se Hee} and Kim, {Eun Kyung} and Kwon, {Hyeong Ju} and Lee, {Eun Jig}",
year = "2014",
month = "11",
day = "21",
doi = "10.1007/s12022-014-9327-6",
language = "English",
volume = "25",
pages = "378--384",
journal = "Endocrine Pathology",
issn = "1046-3976",
publisher = "Humana Press",
number = "4",

}

Thyroid Cancers with Benign-Looking Sonographic Features Have Different Lymph Node Metastatic Risk and Histologic Subtypes According to Nodule Size. / Shin, Dong Yeob; Lee, Young Ki; Kim, Kwang Joon; Park, Kyeong Hye; Hwang, Sena; Park, Se Hee; Kim, Eun Kyung; Kwon, Hyeong Ju; Lee, Eun Jig.

In: Endocrine Pathology, Vol. 25, No. 4, 21.11.2014, p. 378-384.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Thyroid Cancers with Benign-Looking Sonographic Features Have Different Lymph Node Metastatic Risk and Histologic Subtypes According to Nodule Size

AU - Shin, Dong Yeob

AU - Lee, Young Ki

AU - Kim, Kwang Joon

AU - Park, Kyeong Hye

AU - Hwang, Sena

AU - Park, Se Hee

AU - Kim, Eun Kyung

AU - Kwon, Hyeong Ju

AU - Lee, Eun Jig

PY - 2014/11/21

Y1 - 2014/11/21

N2 - 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 (17.9 ± 14.5 vs. 5.6 ± 2.4 mm, P < 0.001), a lower frequency of classical papillary thyroid carcinoma (PTC) (58.6 vs. 87.2 %, P < 0.001), and a higher frequency of follicular variant PTC and follicular thyroid carcinoma (19.7 and 17.8 % vs. 9.4 and 1.5 %, respectively, P < 0.01). In subgroup analysis of 269 patients with classical PTC, the larger nodule size on US was associated with a higher prevalence of LNM (28.3 vs. 14.7 %, P = 0.007). 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.

AB - 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 (17.9 ± 14.5 vs. 5.6 ± 2.4 mm, P < 0.001), a lower frequency of classical papillary thyroid carcinoma (PTC) (58.6 vs. 87.2 %, P < 0.001), and a higher frequency of follicular variant PTC and follicular thyroid carcinoma (19.7 and 17.8 % vs. 9.4 and 1.5 %, respectively, P < 0.01). In subgroup analysis of 269 patients with classical PTC, the larger nodule size on US was associated with a higher prevalence of LNM (28.3 vs. 14.7 %, P = 0.007). 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.

UR - http://www.scopus.com/inward/record.url?scp=84911367296&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84911367296&partnerID=8YFLogxK

U2 - 10.1007/s12022-014-9327-6

DO - 10.1007/s12022-014-9327-6

M3 - Article

C2 - 25182219

AN - SCOPUS:84911367296

VL - 25

SP - 378

EP - 384

JO - Endocrine Pathology

JF - Endocrine Pathology

SN - 1046-3976

IS - 4

ER -