Clinical and ultrasound thyroid nodule characteristics and their association with cytological and histopathological outcomes: A retrospective multicenter study in high-resolution thyroid nodule clinics
Keywords: 
Thyroid nodules
Ultrasound
Fine needle aspiration
Issue Date: 
2019
Publisher: 
MDPI
ISSN: 
2077-0383
Note: 
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
Citation: 
Molina-Vega, M. (María); Rodríguez-Pérez, C.A. (Carlos Antonio); Álvarez-Mancha, A.I. (Ana Isabel); et al. "Clinical and ultrasound thyroid nodule characteristics and their association with cytological and histopathological outcomes: A retrospective multicenter study in high-resolution thyroid nodule clinics". Journal of Clinical Medicine. 8 (12), 2019, 2172
Abstract
Introduction: Thyroid nodules are a common finding. A high-resolution thyroid nodule clinic (HR-TNC) condenses all tests required for the evaluation of thyroid nodules into a single appointment. We aimed to evaluate the clinical outcomes at HR-TNCs. Design and Methods: A retrospective cross-sectional multicenter study including data from four HR-TNCs in Spain. We evaluated fine-needle aspiration (FNA) indications and the association between clinical and ultrasound characteristics with cytological and histopathological outcomes. Results: A total of 2809 thyroid nodules were included; FNA was performed in 82.1%. Thyroid nodules that underwent FNA were more likely larger, isoechoic, with microcalcifications, and in younger subjects. The rate of nondiagnostic FNA was 4.3%. A solid component, irregular margins or microcalcifications, significantly increased the odds of Bethesda IV-V-VI (vs. Bethesda II). Irregular margins and a solid component were independently associated with increased odds of malignancy. Thyroid nodules <20 mm and ≥20–<40 mm had a 6.5-fold and 3.3-fold increased risk for malignancy respectively in comparison with those ≥40 mm. Conclusion: In this large multicenter study, we found that the presence of a solid component and irregular margins are factors independently related to malignancy in thyroid nodules. Since nodule size ≥40 mm was associated with the lowest odds of malignancy, this cut-off should not be a factor leading to indicate thyroid surgery. HR-TNCs were associated with a low rate of nondiagnostic FNA.

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