Association between neck ultrasonographic findings and clinico‐pathological features in the follicular variant of papillary thyroid carcinoma

Publisher： John Wiley & Sons Inc

E-ISSN： 1365-2265|83|6|968-976

ISSN： 0300-0664

Source： CLINICAL ENDOCRINOLOGY, Vol.83, Iss.6, 2015-12, pp. : 968-976

Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.

Previous Menu Next

Abstract

SummaryObjectiveThe follicular variant of papillary thyroid carcinoma (FVPTC) has multiple histological subtypes. Clinical outcomes of FVPTC are variable depending on the subtypes. This study evaluated the association of pre‐operative ultrasonographic (US) findings and clinico‐pathological features of FVPTC.PatientsThis retrospective study enrolled patients with FVPTC (n = 70), size‐matched classical variant of papillary thyroid carcinoma (CPTC, n = 328), follicular carcinoma (n = 85) and follicular adenoma (FA, n = 120). We defined the histological subtypes of FVPTC as infiltrative (I‐FVPTC; n = 19) or encapsulated (E‐FVPTC; n = 51) according to the presence of a fibrous capsule. Pre‐operative US was reviewed using a US scoring system and classified into low US score (n = 42) and high US score (n = 28).ResultsThe median US score for FVPTC was lower than CPTC (2 vs 7, P < 0·001), but higher than FA (2 vs 0, P < 0·001). The median US score for I‐FVPTC was significantly higher than E‐FVPTC (4 vs 2, P = 0·009). I‐FVPTC was more likely to be diagnosed as a malignancy or suspicious for malignancy on cytology than E‐FVPTC (P = 0·002). The cumulative risks of cervical lymph node (LN) or distant metastasis according to tumour size were significantly higher in I‐FVPTC than E‐FVPTC (all P < 0·001). The cumulative risks for cervical LN metastasis or capsular invasion according to tumour size were significantly higher in FVPTC with high US score than FVPTC with low US score (P = 0·005, P < 0·001, respectively).ConclusionsPre‐operative US findings of thyroid nodules were associated with not only histological subtypes, but also the clinical behaviour in FVPTC.