Operation rate and cancer prevalence among thyroid nodules with FNAC report of suspicious for malignancy (TIR4) or malignant (TIR5) according to Italian classification system: a systematic review and meta-analysis
-
Published:2022-08-20
Issue:1
Volume:78
Page:24-31
-
ISSN:1559-0100
-
Container-title:Endocrine
-
language:en
-
Short-container-title:Endocrine
Author:
Trimboli PierpaoloORCID, Ferrarazzo Giulia, Piccardo Arnoldo, Lucchini Barbara, Durante Cosimo
Abstract
Abstract
Background
In the Italian system for reporting thyroid cytology (ICCRTC), nodules suspicious for (TIR4) and consistent with (TIR5) malignancy are thought being 5% and 4–8% of all biopsies and having risk of malignancy of 60–80% and >95%, respectively. However, no evidence-based data exist about these figures. The present systematic review aimed at achieving solid estimates about TIR4 and TIR5 also considering potential influencing factors.
Methods
The review was conducted according to MOOSE. Databases of Google Scholar and Cochrane were searched. No language restriction was used. The last search was performed on February 26th 2022. Quality assessment was performed. Proportion meta-analyses were performed using random-effect model. Statistical analyses were performed using OpenMeta [Analyst].
Results
The online search retrieved 271 articles and 16 were finally included for quantitative analysis. The risk of bias was generally low. The pooled cancer prevalence in TIR4 was 92.5% (95%CI 89.4–95.6%) with unexplained moderate heterogeneity. The pooled cancer rate among TIR5 was 99.7% (95%CI 99.3–100%) without heterogeneity. The resection rate in TIR4 and TIR5 showed heterogeneity, being the latter explained when using their prevalence among biopsies: the higher the prevalence, the higher the operation rate. The pooled risk difference between TIR5 and TIR4 was significant (OR 11.153).
Conclusions
These figures can form the basis for the next updated version of ICCRTC. Any institution using ICCRTC should revise its series of TIR4/TIR5 to calculate the cancer rate, and, importantly, consider the modifiers of the risk of malignancy. A cross check among institutions is advised.
Publisher
Springer Science and Business Media LLC
Subject
Endocrinology,Endocrinology, Diabetes and Metabolism
Reference32 articles.
1. H. Gharib, E. Papini, R. Paschke, D.S. Duick, R. Valcavi, L. Hegedüs, P. Vitti, AACE/AME/ETA Task Force on Thyroid Nodules: American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association Medical Guidelines for Clinical Practice for the Diagnosis and Management of Thyroid Nodules. Endocr. Pract. 16, 1–43 (2010) 2. B.R. Haugen, E.K. Alexander, K.C. Bible, G.M. Doherty, S.J. Mandel, Y.E. Nikiforov, F. Pacini, G.W. Randolph, A.M., Sawka, A.M. Schlumberger, M. Schuff, K.G. Sherman, S.I., Sosa, J.A., Steward, D.L., Tuttle, R.M., Wartofsky, L., American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid (2016). https://doi.org/10.1089/thy.2015.0020 3. P. Perros, K. Boelaert, S. Colley, C. Evans, R.M. Evans, G.G. Ba, J. Gilbert, B. Harrison, S.J. Johnson, T.E. Giles, L. Moss, V. Lewington, K. Newbold, J. Taylor, R.V. Thakker, J. Watkinson, G.R. Williams, British Thyroid Association: Guidelines for the management of thyroid cancer. Clin. Endocrinol. (2014). https://doi.org/10.1111/cen.12515 4. S.Z. Ali, E. Cibas, The Bethesda System for Reporting Thyroid Cytopathology. 2nd edition. Cham, Switzerland, Springer (2017). 5. G. Fadda, F. Basolo, A. Bondi, G. Bussolati, A. Crescenzi, O. Nappi, F. Nardi, M. Papotti, G. Taddei, L. Palombini; SIAPEC-IAP Italian Consensus Working Group, Cytological classification of thyroid nodules. Proposal of the SIAPEC-IAP Italian Consensus Working Group. Pathologica 102, 405–408 (2010)
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|