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2015 ; 4
(3
): 189-96
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Role of Core Needle Biopsy in the Management of Atypia/Follicular Lesion of
Undetermined Significance Thyroid Nodules: Comparison with Repeat Fine-Needle
Aspiration in Subcategory Nodules
#MMPMID26558236
Na DG
; Min HS
; Lee H
; Won JK
; Seo HB
; Kim JH
Eur Thyroid J
2015[Sep]; 4
(3
): 189-96
PMID26558236
show ga
BACKGROUND: The role of repeat fine-needle aspiration (RFNA) or core needle
biopsy (CNB) has not been established in nodules categorized as atypia/follicular
lesion of undetermined significance (AUS/FLUS). OBJECTIVE: The purpose of this
study was to retrospectively determine whether CNB is more useful for management
decisions than RFNA at each subcategory of AUS/FLUS nodules. METHODS: This study
included 158 AUS/FLUS nodules (?1 cm) from 153 consecutive patients who underwent
both RFNA and CNB. The AUS/FLUS nodules were subcategorized into nuclear atypia
(NA) and follicular lesions with other atypia (FOA). The diagnostic results and
rate of determined management by RFNA and CNB were compared at each subcategory.
The diagnostic values of RFNA and CNB for malignancy were evaluated in nodules
with final diagnoses. RESULTS: CNB showed a lower rate of AUS/FLUS diagnosis,
higher rates of benign and follicular neoplasm or suspicious for a follicular
neoplasm (FN/SFN) diagnoses (p ? 0.038), and marginally higher rates of malignant
diagnosis than RFNA in the NA subcategory. CNB showed a higher rate of FN/SFN (p
= 0.007) than RFNA in the FOA subcategory. CNB also demonstrated a higher rate of
surgery decision than RFNA in both the NA subcategory (20.2 vs. 9.6%, p < 0.001)
and FOA subcategory (20.8 vs. 5.6%, p = 0.007), and a higher rate of observation
decision only in the NA subcategory (48.1 vs. 35.6%, p = 0.035). CNB demonstrated
a higher diagnostic performance for malignancy overall in the nodules compared
with RFNA. CONCLUSION: CNB may be more useful for management decisions than RFNA
in both the NA and FOA subcategories, and has the potential to be a first-line
alternative diagnostic tool in initially diagnosed AUS/FLUS nodules.