Impact of reclassifying noninvasive follicular variant of papillary thyroid carcinoma on the risk of malignancy in the Bethesda System for Reporting Thyroid Cytopathology

William C. Faquin, Lawrence Q. Wong, Amir H. Afrogheh, Syed Z Ali, Justin A. Bishop, Massimo Bongiovanni, Marc P. Pusztaszeri, Christopher VandenBussche, Jolanta Gourmaud, Louis J. Vaickus, Zubair W. Baloch

Research output: Contribution to journalArticle

Abstract

BACKGROUND Recent discussions have focused on redefining noninvasive follicular variant of papillary thyroid carcinoma (NI-FVPTC) as a neoplasm rather than a carcinoma. This study assesses the potential impact of such a reclassification on the implied risk of malignancy (ROM) for the diagnostic categories of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). METHODS The study consisted of consecutive fine-needle aspiration biopsy (FNAB) cases collected between January 1, 2013 and June 30, 2014 from 5 academic institutions. Demographic information, cytology diagnoses, and surgical pathology follow-up were recorded. The ROM was calculated with and without NI-FVPTC and was presented as a range: All cases (ie, overall risk of malignancy [OROM]) versus those with surgical follow-up only. RESULTS The FNAB cohort consisted of 6943 thyroid nodules representing 5179 women and 1409 men with an average age of 54 years (range, 9-94 years). The combined average ROM and OROM for the diagnostic categories of TBSRTC were as follows: nondiagnostic, 4.4% to 25.3%; benign, 0.9% to 9.3%; atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), 12.1% to 31.2%; follicular neoplasm (FN), 21.8% to 33.2%; suspicious for malignancy (SM), 62.1% to 82.6%; and malignant, 75.9% to 99.1%. The impact of reclassifying NI-FVPTC on the ROM and OROM was most pronounced and statistically significant in the 3 indeterminate categories: The AUS/FLUS category had a decrease of 5.2% to 13.6%, the FN category had a decrease of 9.9% to 15.1%, and the SM category had a decrease of 17.6% to 23.4% (P

Original languageEnglish (US)
Pages (from-to)181-187
Number of pages7
JournalCancer cytopathology
Volume124
Issue number3
DOIs
StatePublished - Mar 1 2016

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Thyroid Gland
Neoplasms
Fine Needle Biopsy
Papillary Thyroid cancer
Surgical Pathology
Thyroid Nodule
Cell Biology
Demography
Carcinoma

Keywords

  • atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS)
  • Bethesda
  • fine-needle aspiration (FNA)
  • follicular variant
  • noninvasive
  • noninvasive follicular thyroid (NIFT)
  • papillary thyroid carcinoma
  • thyroid

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Impact of reclassifying noninvasive follicular variant of papillary thyroid carcinoma on the risk of malignancy in the Bethesda System for Reporting Thyroid Cytopathology. / Faquin, William C.; Wong, Lawrence Q.; Afrogheh, Amir H.; Ali, Syed Z; Bishop, Justin A.; Bongiovanni, Massimo; Pusztaszeri, Marc P.; VandenBussche, Christopher; Gourmaud, Jolanta; Vaickus, Louis J.; Baloch, Zubair W.

In: Cancer cytopathology, Vol. 124, No. 3, 01.03.2016, p. 181-187.

Research output: Contribution to journalArticle

Faquin, William C. ; Wong, Lawrence Q. ; Afrogheh, Amir H. ; Ali, Syed Z ; Bishop, Justin A. ; Bongiovanni, Massimo ; Pusztaszeri, Marc P. ; VandenBussche, Christopher ; Gourmaud, Jolanta ; Vaickus, Louis J. ; Baloch, Zubair W. / Impact of reclassifying noninvasive follicular variant of papillary thyroid carcinoma on the risk of malignancy in the Bethesda System for Reporting Thyroid Cytopathology. In: Cancer cytopathology. 2016 ; Vol. 124, No. 3. pp. 181-187.
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abstract = "BACKGROUND Recent discussions have focused on redefining noninvasive follicular variant of papillary thyroid carcinoma (NI-FVPTC) as a neoplasm rather than a carcinoma. This study assesses the potential impact of such a reclassification on the implied risk of malignancy (ROM) for the diagnostic categories of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). METHODS The study consisted of consecutive fine-needle aspiration biopsy (FNAB) cases collected between January 1, 2013 and June 30, 2014 from 5 academic institutions. Demographic information, cytology diagnoses, and surgical pathology follow-up were recorded. The ROM was calculated with and without NI-FVPTC and was presented as a range: All cases (ie, overall risk of malignancy [OROM]) versus those with surgical follow-up only. RESULTS The FNAB cohort consisted of 6943 thyroid nodules representing 5179 women and 1409 men with an average age of 54 years (range, 9-94 years). The combined average ROM and OROM for the diagnostic categories of TBSRTC were as follows: nondiagnostic, 4.4{\%} to 25.3{\%}; benign, 0.9{\%} to 9.3{\%}; atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), 12.1{\%} to 31.2{\%}; follicular neoplasm (FN), 21.8{\%} to 33.2{\%}; suspicious for malignancy (SM), 62.1{\%} to 82.6{\%}; and malignant, 75.9{\%} to 99.1{\%}. The impact of reclassifying NI-FVPTC on the ROM and OROM was most pronounced and statistically significant in the 3 indeterminate categories: The AUS/FLUS category had a decrease of 5.2{\%} to 13.6{\%}, the FN category had a decrease of 9.9{\%} to 15.1{\%}, and the SM category had a decrease of 17.6{\%} to 23.4{\%} (P",
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AU - Ali, Syed Z

AU - Bishop, Justin A.

AU - Bongiovanni, Massimo

AU - Pusztaszeri, Marc P.

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N2 - BACKGROUND Recent discussions have focused on redefining noninvasive follicular variant of papillary thyroid carcinoma (NI-FVPTC) as a neoplasm rather than a carcinoma. This study assesses the potential impact of such a reclassification on the implied risk of malignancy (ROM) for the diagnostic categories of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). METHODS The study consisted of consecutive fine-needle aspiration biopsy (FNAB) cases collected between January 1, 2013 and June 30, 2014 from 5 academic institutions. Demographic information, cytology diagnoses, and surgical pathology follow-up were recorded. The ROM was calculated with and without NI-FVPTC and was presented as a range: All cases (ie, overall risk of malignancy [OROM]) versus those with surgical follow-up only. RESULTS The FNAB cohort consisted of 6943 thyroid nodules representing 5179 women and 1409 men with an average age of 54 years (range, 9-94 years). The combined average ROM and OROM for the diagnostic categories of TBSRTC were as follows: nondiagnostic, 4.4% to 25.3%; benign, 0.9% to 9.3%; atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), 12.1% to 31.2%; follicular neoplasm (FN), 21.8% to 33.2%; suspicious for malignancy (SM), 62.1% to 82.6%; and malignant, 75.9% to 99.1%. The impact of reclassifying NI-FVPTC on the ROM and OROM was most pronounced and statistically significant in the 3 indeterminate categories: The AUS/FLUS category had a decrease of 5.2% to 13.6%, the FN category had a decrease of 9.9% to 15.1%, and the SM category had a decrease of 17.6% to 23.4% (P

AB - BACKGROUND Recent discussions have focused on redefining noninvasive follicular variant of papillary thyroid carcinoma (NI-FVPTC) as a neoplasm rather than a carcinoma. This study assesses the potential impact of such a reclassification on the implied risk of malignancy (ROM) for the diagnostic categories of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). METHODS The study consisted of consecutive fine-needle aspiration biopsy (FNAB) cases collected between January 1, 2013 and June 30, 2014 from 5 academic institutions. Demographic information, cytology diagnoses, and surgical pathology follow-up were recorded. The ROM was calculated with and without NI-FVPTC and was presented as a range: All cases (ie, overall risk of malignancy [OROM]) versus those with surgical follow-up only. RESULTS The FNAB cohort consisted of 6943 thyroid nodules representing 5179 women and 1409 men with an average age of 54 years (range, 9-94 years). The combined average ROM and OROM for the diagnostic categories of TBSRTC were as follows: nondiagnostic, 4.4% to 25.3%; benign, 0.9% to 9.3%; atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), 12.1% to 31.2%; follicular neoplasm (FN), 21.8% to 33.2%; suspicious for malignancy (SM), 62.1% to 82.6%; and malignant, 75.9% to 99.1%. The impact of reclassifying NI-FVPTC on the ROM and OROM was most pronounced and statistically significant in the 3 indeterminate categories: The AUS/FLUS category had a decrease of 5.2% to 13.6%, the FN category had a decrease of 9.9% to 15.1%, and the SM category had a decrease of 17.6% to 23.4% (P

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