Preoperative Ultrasonography in the Evaluation of Suspected Familial Non-Medullary Thyroid Cancer: Are We Able to Predict Multifocality and Extrathyroidal Extension?

被引:6
作者
Grani, Giorgio [1 ]
Cera, Gianluca [1 ]
Conzo, Giovanni [2 ]
Del Gatto, Valeria [1 ]
di Gioia, Cira Rosaria Tiziana [3 ]
Maranghi, Marianna [1 ]
Lucia, Piernatale [1 ]
Cantisani, Vito [3 ]
Metere, Alessio [4 ]
Melcarne, Rossella [4 ]
Borcea, Maria Carola [4 ]
Scorziello, Chiara [4 ]
Menditto, Rosa [4 ]
Summa, Marco [4 ]
Biffoni, Marco [4 ]
Durante, Cosimo [1 ]
Giacomelli, Laura [4 ]
机构
[1] Sapienza Univ Rome, Dept Translat & Precis Med, Viale Policlin 155, I-00161 Rome, Italy
[2] Univ Campania Luigi Vanvitelli, Dept Cardiothorac Sci, I-80131 Naples, Italy
[3] Sapienza Univ Rome, Dept Radiol Oncol & Pathol Sci, Viale Policlin 155, I-00161 Rome, Italy
[4] Sapienza Univ Rome, Dept Surg Sci, Viale Policlin 155, I-00161 Rome, Italy
关键词
TIRADS; thyroid cancer; thyroid nodules; multifocality; SONOGRAPHIC ASSESSMENT; TASK-FORCE; FOLLOW-UP; PAPILLARY; HISTORY; SURVEILLANCE; RECURRENCE; ULTRASOUND; GUIDELINES; CARCINOMA;
D O I
10.3390/jcm10225277
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Family history of thyroid cancer increases the risk of harboring thyroid malignancies that end up having extrathyroidal extension (ETE) and multifocality on histology; some authors suggest a more aggressive surgical approach. Their pre-operative identification could allow more conservative surgical procedures if none of these features are suspected. Our aim was to assess if neck ultrasonography could identify or exclude multifocality or ETE in these patients to tailor the extent of surgery. This retrospective study included patients with previous thyroid surgery, >= 1 first-grade relative with thyroid cancer, and who had undergone pre-surgical ultrasound. ETE was suspected in the case of thyroid border interruption or gross invasion of perithyroidal tissues. Multiple suspicious nodules were defined as suspicion of multifocal cancer. The cohort consisted of 45 patients (median age 49 years, 40 with thyroid cancer, 30 females). The positive predictive value of ultrasonography in predicting multifocality and ETE was 57.14% (25.25-84.03) and 41.67% (21.5-65.1%), respectively, while the negative predictive values were 63.2% (56.4-69.4%) and 72.7% (63.3-80.5%). Pre-operative ultrasound examination is unable to reliably identify or exclude multifocal disease or extrathyroidal extension. In patients scheduled for surgery and with a first-degree relative affected by DTC, a "negative" pre-operative US report does not exclude the potential finding of multifocality and ETE at final histopathology.
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页数:8
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