Limitations of preoperative cytology for medullary thyroid cancer: Proposal for improved preoperative diagnosis for optimal initial medullary thyroid carcinoma specific surgery

被引：17

作者：

Workman, Alan D. ^{[1
,2
]}

Soylu, Selen ^{[1
,2
]}

Kamani, Dipti ^{[1
,2
]}

Nourmahnad, Anahita ^{[2
]}

Kyriazidis, Natalia ^{[1
,2
]}

Saade, Ryan ^{[1
,2
]}

Ren, Yin ^{[1
,2
]}

Wirth, Lori ^{[3
]}

Faquin, William C. ^{[2
,4
]}

Onenerk, Ayse M. ^{[5
]}

Nikiforov, Yuri E. ^{[6
]}

Al-Qurayshi, Zaid ^{[7
]}

Kandil, Emad ^{[8
]}

Kloos, Richard T. ^{[9
]}

Eldeiry, Leslie ^{[10
]}

Lubitz, Carrie ^{[11
,12
]}

Stathatos, Nikolaos ^{[13
]}

Randolph, Gregory W. ^{[1
,2
,14
]}

机构：

[1] Massachusetts Eye & Ear, Dept Otolaryngol, Div Thyroid & Parathyroid Surg, 243 Charles St, Boston, MA 02114 USA

[2] Harvard Med Sch, Boston, MA 02115 USA

[3] Harvard Med Sch, Massachusetts Gen Hosp, Dept Med, Boston, MA 02115 USA

[4] Massachusetts Gen Hosp, Dept Pathol, Boston, MA 02114 USA

[5] Haydarpasa Numune Training & Res Hosp, Dept Pathol, Istanbul, Turkey

[6] Univ Pittsburgh, Med Ctr, Dept Pathol, Pittsburgh, PA USA

[7] Univ Iowa Hosp & Clin, Dept Otolaryngol Head & Neck Surg, Iowa City, IA 52242 USA

[8] Tulane Univ, Sch Med, Dept Surg, New Orleans, LA 70112 USA

[9] Veracyte Inc, Dept Med Affairs, San Francisco, CA USA

[10] Atrius Hlth, Harvard Vanguard Med Associates, Boston, MA USA

[11] Massachusetts Gen Hosp, Dept Surg, Boston, MA 02114 USA

[12] Massachusetts Gen Hosp, Inst Technol Assessment, Boston, MA 02114 USA

[13] Massachusetts Gen Hosp, Thyroid Unit, Boston, MA 02114 USA

[14] Harvard Med Sch, Massachusetts Gen Hosp, Dept Surg, Div Surg Oncol, Boston, MA 02115 USA

来源：

HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK | 2021年 / 43卷 / 03期

关键词：

cytology; medullary thyroid cancer; MTC; MTC detection; optimal surgery; preoperative diagnosis; FINE-NEEDLE-ASPIRATION; ASSOCIATION GUIDELINES; CALCITONIN MEASUREMENT; PREDICTIVE-VALUE; MANAGEMENT; EXPERIENCE; SURVIVAL; NODULES; EXTENT;

D O I：

10.1002/hed.26550

中图分类号：

R76 [耳鼻咽喉科学];

学科分类号：

100213 ;

摘要：

Background Preoperative diagnosis of medullary thyroid carcinoma (MTC) is often difficult, given the poor sensitivity of fine-needle aspiration (FNA) cytology for MTC. This study investigates this issue and presents recommendations for improving preoperative diagnostic paradigms in MTC cases. Design/Method Histopathologically confirmed MTC patients with preoperative cytologic assessment of index nodules were enrolled. FNA diagnosis, final pathology, and surgery details were collected. Results Out of 71 patients, 49 (69%) were diagnosed by FNA as either definitive MTC (35, 49%) or suspected MTC (14, 20%) and 22 (31%) patients had no indication of MTC on FNA. Conclusion In a tertiary-care setting, one-third of subjects had an FNA interpretation that did not suggest the possibility of MTC. The limitations of preoperative diagnosis are especially problematic for MTC as they can cause delayed or incomplete treatment. Additional testing is proposed to improve preoperative diagnosis and surgical care of MTC patients.

引用

页码：920 / 927

页数：8

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