caa a22 4500 445335335 CHVBK 20180317142752.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1245/s10434-011-1635-1 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1635-1 Predictive Value of Cytologic Atypia in Indeterminate Thyroid Fine-Needle Aspirate Biopsies [Elektronische Daten] [Meredith Kato, Daniel Buitrago, Tracy-Ann Moo, Xavier Keutgen, Raza Hoda, Joseph Ricci, Paul Christos, Grace Yang, Thomas Fahey III, Rasa Zarnegar] Background: Fine-needle aspiration (FNA) biopsies are the most accurate method for diagnosis of thyroid nodules. Unfortunately, biopsies are indeterminate 15-30% of the time and surgery is thus required for a definitive diagnosis. We aimed to determine whether specific descriptors of cytologic atypia mentioned in indeterminate FNA reports were associated with malignancy on final histopathology. Methods: Retrospective review of 1000 surgery patients identified 466 indeterminate FNA lesions that underwent either a hemi- or total thyroidectomy between 1998 and 2009. We screened FNA reports for specific descriptors of nuclear atypia. Univariate and multivariate analyses were performed to evaluate the independent effect of cytologic atypia descriptors on the risk of malignancy. Results: Nuclear atypia on FNA conferred a risk of malignancy of 42% (P<0.0001). Risk of malignancy increased from 17% for zero descriptors to 81.2% when four or more descriptors of atypia were described. Nuclear grooves and inclusions together conferred a risk of malignancy, specificity, and false positive rate of 79.3%, 98.2% and 1.8% respectively. Conclusions: The presence of four or more descriptors of cytologic atypia or the presence of both nuclear inclusions and grooves together confers a high risk of malignancy on final histopathology and a low false positive rate. These findings should be taken into consideration when interpreting FNA reports and total thyroidectomy should be considered for those patients at higher risk. Society of Surgical Oncology, 2011 Kato Meredith Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY, USA aut Buitrago Daniel Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY, USA aut Moo Tracy-Ann Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY, USA aut Keutgen Xavier Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY, USA aut Hoda Raza Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY, USA aut Ricci Joseph Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY, USA aut Christos Paul Department of Public Health, Weill Cornell Medical College, New York, NY, USA aut Yang Grace Department of Pathology, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY, USA aut Fahey III Thomas Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY, USA aut Zarnegar Rasa Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY, USA aut Annals of Surgical Oncology Springer-Verlag 18/10(2011-10-01), 2893-2898 1068-9265 18:10<2893 2011 18 10434 https://doi.org/10.1245/s10434-011-1635-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1635-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kato Meredith Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY, USA aut NATIONALLICENCE 700 1- Buitrago Daniel Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY, USA aut NATIONALLICENCE 700 1- Moo Tracy-Ann Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY, USA aut NATIONALLICENCE 700 1- Keutgen Xavier Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY, USA aut NATIONALLICENCE 700 1- Hoda Raza Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY, USA aut NATIONALLICENCE 700 1- Ricci Joseph Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY, USA aut NATIONALLICENCE 700 1- Christos Paul Department of Public Health, Weill Cornell Medical College, New York, NY, USA aut NATIONALLICENCE 700 1- Yang Grace Department of Pathology, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY, USA aut NATIONALLICENCE 700 1- Fahey III Thomas Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY, USA aut NATIONALLICENCE 700 1- Zarnegar Rasa Department of Surgery, New York Presbyterian Hospital-Weill Cornell Medical College, New York, NY, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/10(2011-10-01), 2893-2898 1068-9265 18:10<2893 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer