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The McGill Thyroid Nodule Score's (MTNS+) role in the investigation of thyroid nodules with benign ultrasound guided fine needle aspiration biopsies: a retrospective review.
- Source :
-
Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale [J Otolaryngol Head Neck Surg] 2016 May 04; Vol. 45 (1), pp. 29. Date of Electronic Publication: 2016 May 04. - Publication Year :
- 2016
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Abstract
- Background: Ultrasound guided fine needle aspiration (USFNA) biopsies of thyroid nodules sometimes create a decision-making dilemma for surgeons as they may yield falsely benign results. The McGill Thyroid Nodule Score + (MTNS+) was developed to aid in clinical guidance regarding the management of patients with these USFNA results. The aim of this study was to assess the MTNS+ as a clinical tool in patients with benign preoperative thyroid nodule USFNAs and to analyze the relationship between nodule size and malignancy in these patients.<br />Methods: We conducted a retrospective chart review of 1312 patients who underwent thyroidectomies between 2010 and 2015 at the McGill University Teaching Hospitals. Patients with Bethesda II (benign) USFNA results, calculated MTNS+, and nodule size evaluated on ultrasound were included in the study. The false-negative rate was calculated, and MTNS+ and nodule size were each compared to final pathology results. Binary logistic regression was used for statistical analysis.<br />Results: Of the 1312 patients, 101 met the inclusion criteria and together had an average MTNS+ score of 6.83, which corresponds to a predicted malignancy rate between 25 and 33 %. Final pathology revealed malignancy in 16 (15.8 %) subjects. The average MTNS+ of patients with malignant nodules on surgical pathology was 8.25, while that of patients with benign nodules was 6.56. Patients with nodule size 1-1.9 cm (a) and 2-2.9 cm (b) each had an equal rate of malignancy of 2.97 % (n = 3), nodule size 3-3.9 cm (c) had a rate of 1.98 % (n = 2), and nodule size ≥4 cm (d) a rate of 7.92 % (n = 8).<br />Conclusion: The rate of malignancy (15.8 %) is higher than expected when reviewing the risk of malignancy in nodules considered as Bethesda class 2. On the other hand, the rate is lower than the 25-33 % predicted by the MTNS+. We also found a higher malignancy rate for nodules above 4 cm in size, but size was a poor predictor of malignancy when used alone. Therefore, while the MTNS+ may be helpful at helping to identify USFNAs that are incorrectly classified as benign, the percentage risk of malignancy is lower than expected.
- Subjects :
- Adult
Aged
Aged, 80 and over
Diagnosis, Differential
Female
Humans
Male
Middle Aged
Retrospective Studies
Sex Factors
Thyroid Neoplasms surgery
Thyroid Nodule surgery
Thyroidectomy
Biopsy, Fine-Needle
Image-Guided Biopsy
Thyroid Neoplasms pathology
Thyroid Nodule pathology
Ultrasonography, Interventional
Subjects
Details
- Language :
- English
- ISSN :
- 1916-0216
- Volume :
- 45
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale
- Publication Type :
- Academic Journal
- Accession number :
- 27142264
- Full Text :
- https://doi.org/10.1186/s40463-016-0141-7