Diseño de una escala ecográfica predictora de malignidad en nódulos tiroideos: Comunicación preliminar

Domínguez, José Miguel; Baudrand, Rene; Arteaga, Eugenio; Campusano, Claudia; González, Gilberto; Mosso, Lorena; Cavada, Gabriel; Cruz, Francisco; Torres, Javiera; Solar, Antonieta; Arias, Tatiana; Pizarro, Alejandra; Gomez, Marcelo; Fardella, Carlos

Abstract

"Background: Thyroid nodules are common and associated to a low risk of malignancy. Their clinical assessment usually includes a fine neddle aspiration biopsy (FNAB). Aim To identify ultrasonographic characteristics associated to papillary thyroid carcinoma (PTC) and generate a score that predicts the risk of PTC. Material and methods: Retrospective review of all fine needle aspiration biopsies of the thyroid performed in a lapse of two years. Biopsies that were conclusive for PTC were selected and compared with an equal amount of randomly selected biopsies that disclosed a benign diagnosis. Results: One hundred twenty two biopsies of a total of 1,498 were conclusive for PTC. Univariate analysis showed associations with PTC for the presence of micro-calcifications (Odds ratio (OR) 49.2: 95% confidence intervals (CI) 18.7-140.9), solid predominance (OR 25.1; 95% CI 6-220), hypoechogenicity (OR 23.5, 95% CI 6.5-122.6), irregular borders (OR 17, 95% CI 7.2-42.9), lymph node involvement (OR 12.3, 95% CI2.7-112), central vascularization (OR 12.2, 95% CI 4.8-33.3), local invasion and hyperechogenicity (OR 0.2; CI95% CI 0.03-0.6). Multivariate analysis disclosed microcalcifications (OR 28.1; CI 95% 8.9-89), hypoechogenicity (OR 9.4; 95% CI 1.5-59.5) and irregular borders (OR 4.7; CI 95% 1.5-15) as the variables independently associated with the presence of PTC. The prevalence of PTC in the presence of the three variables was 97.6% (Likelihood ratio (LR) 45) and 5.4% in their absence (LR 0.06). Conclusions: This scale predicts the presence or absence of PTC using simple ultrasound characteristics."

Más información

Título según SCIELO: Diseño de una escala ecográfica predictora de malignidad en nódulos tiroideos: Comunicación preliminar
Título de la Revista: REVISTA MEDICA DE CHILE
Volumen: 137
Número: 8
Editorial: SOC MEDICA SANTIAGO
Fecha de publicación: 2009
Página de inicio: 1031
Página final: 1036
Idioma: es
URL: http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872009000800005&lng=en&nrm=iso&tlng=en
DOI:

10.4067/S0034-98872009000800005

Notas: SCIELO