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Conference Paper: Subcategorisation: Improved Stratification of Thyroid Nodule with Cytological Results of Atypia of Undetermined Significance

TitleSubcategorisation: Improved Stratification of Thyroid Nodule with Cytological Results of Atypia of Undetermined Significance
Authors
Issue Date2016
PublisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/ASH
Citation
The 2016 Conjoint Scientific Congress of The Royal College of Surgeons of Edinburgh and College of Surgeons of Hong Kong (RCSEd/CSHK): Making Wise Choices in Surgery, Hong Kong, 17-18 September 2016. In Surgical Practice, 2016, v. 20 n. Suppl. 2, p. 12-13, abstract no. EFP13 How to Cite?
AbstractAim: According to Bethesda Classification for cytology assessment of thyroid nodule, malignancy rate of 'atypia of undetermined significance' ranged from 5 to 15 %. However, AUS represented a heterogenous group of cytology features and reported rate of malignancy was up to 38%. We aim to subcategorise AUS nodules and determine their malignancy risk. Methods: 1075 thyroidectomies were performed between January 2013 and September 2015. 783 cytology specimens were obtained preoperatively, in which 158 (20.2%) were AUS. The cytology results were reviewed and subclassified into four subgroups: AUS cannot exclude papillary carcinoma (AUS-PTC), AUS cannot exclude follicular neoplasm (AUS-FN), AUS cannot exclude Hürthle cell neoplasm (AUS-HCN), and AUS not otherwise specified (AUS-NOS). The malignancy risk was determined with final pathology. Results: In 158 nodules with AUS, 35.4% (56/158) patients had malignant thyroid nodule. However, 11 of them were incidental finding. Therefore, only 45 patients' nodule with AUS was finally diagnosed as malignant. 14.5% (23/158) had repeat FNAC. Repeat cytology was unsatisfactory in 30.4% (7/23), benign in 17.4% (4/23), AUS in 43.4%(10/23), suspicious for malignancy in 8.7% (2/23). Nodules were subcategorised into AUS-PTC (43/158, 27.2%), AUS-FN (59/158, 37.3%), AUS-HCN (12/158, 7.6%) and AUS-NOS (44/158, 27.8%). Malignancy rate was 34.9% for AUS-PTC (15/43), 23.7% for AUS-FN (14/59), 33.3% for AUS-HCN (4/12) and 27.3% for AUS-NOS (12/44). Conclusion: Malignancy rate of AUS nodules is higher than previously reported. AUS-PTC has higher risk of malignancy than other subcategories. This suggests distinct cytomorphological feature may better predict malignancy and subcategorisation may have potential clinical implication in guiding management.
DescriptionThis Suppl. is the Special Issue: RCSEd/CSHK Conjoint Scientific Congress 2016, Making Wise Choices in Surgery, 17–18 September 2016, Aberdeen, Hong Kong
Extra Free Paper Session II
Persistent Identifierhttp://hdl.handle.net/10722/243399
ISSN
2013 Impact Factor: 0.172
2015 SCImago Journal Rankings: 0.121

 

DC FieldValueLanguage
dc.contributor.authorLiu, GYL-
dc.contributor.authorWong, KP-
dc.contributor.authorChan, MP-
dc.contributor.authorLang, HHB-
dc.date.accessioned2017-08-25T02:54:20Z-
dc.date.available2017-08-25T02:54:20Z-
dc.date.issued2016-
dc.identifier.citationThe 2016 Conjoint Scientific Congress of The Royal College of Surgeons of Edinburgh and College of Surgeons of Hong Kong (RCSEd/CSHK): Making Wise Choices in Surgery, Hong Kong, 17-18 September 2016. In Surgical Practice, 2016, v. 20 n. Suppl. 2, p. 12-13, abstract no. EFP13-
dc.identifier.issn1744-1625-
dc.identifier.urihttp://hdl.handle.net/10722/243399-
dc.descriptionThis Suppl. is the Special Issue: RCSEd/CSHK Conjoint Scientific Congress 2016, Making Wise Choices in Surgery, 17–18 September 2016, Aberdeen, Hong Kong-
dc.descriptionExtra Free Paper Session II-
dc.description.abstractAim: According to Bethesda Classification for cytology assessment of thyroid nodule, malignancy rate of 'atypia of undetermined significance' ranged from 5 to 15 %. However, AUS represented a heterogenous group of cytology features and reported rate of malignancy was up to 38%. We aim to subcategorise AUS nodules and determine their malignancy risk. Methods: 1075 thyroidectomies were performed between January 2013 and September 2015. 783 cytology specimens were obtained preoperatively, in which 158 (20.2%) were AUS. The cytology results were reviewed and subclassified into four subgroups: AUS cannot exclude papillary carcinoma (AUS-PTC), AUS cannot exclude follicular neoplasm (AUS-FN), AUS cannot exclude Hürthle cell neoplasm (AUS-HCN), and AUS not otherwise specified (AUS-NOS). The malignancy risk was determined with final pathology. Results: In 158 nodules with AUS, 35.4% (56/158) patients had malignant thyroid nodule. However, 11 of them were incidental finding. Therefore, only 45 patients' nodule with AUS was finally diagnosed as malignant. 14.5% (23/158) had repeat FNAC. Repeat cytology was unsatisfactory in 30.4% (7/23), benign in 17.4% (4/23), AUS in 43.4%(10/23), suspicious for malignancy in 8.7% (2/23). Nodules were subcategorised into AUS-PTC (43/158, 27.2%), AUS-FN (59/158, 37.3%), AUS-HCN (12/158, 7.6%) and AUS-NOS (44/158, 27.8%). Malignancy rate was 34.9% for AUS-PTC (15/43), 23.7% for AUS-FN (14/59), 33.3% for AUS-HCN (4/12) and 27.3% for AUS-NOS (12/44). Conclusion: Malignancy rate of AUS nodules is higher than previously reported. AUS-PTC has higher risk of malignancy than other subcategories. This suggests distinct cytomorphological feature may better predict malignancy and subcategorisation may have potential clinical implication in guiding management.-
dc.languageeng-
dc.publisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/ASH-
dc.relation.ispartofSurgical Practice-
dc.titleSubcategorisation: Improved Stratification of Thyroid Nodule with Cytological Results of Atypia of Undetermined Significance-
dc.typeConference_Paper-
dc.identifier.emailWong, KP: kpwongb@hku.hk-
dc.identifier.emailLang, HHB: Blang@hku.hk-
dc.identifier.authorityWong, KP=rp02007-
dc.identifier.authorityLang, HHB=rp01828-
dc.identifier.doi10.1111/1744-1633.12206-
dc.identifier.hkuros274408-
dc.identifier.volume20-
dc.identifier.issueSuppl. 2-
dc.identifier.spage12-
dc.identifier.epage13-
dc.publisher.placeAustralia-

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