Computerized Cytological Features for Papillary Thyroid Cancer Diagnosis-Preliminary Report.

Shyang-Rong Shih,Wan-Yu Chuang,Chih-Yuan Wang,Kuen-Yuan Chen,Argon Chen,Yung-Lien Hsiao,I-Shiow Jan,Tien-Chun Chang

doi:10.3390/cancers11111645

Shyang-Rong Shih, Wan-Yu Chuang + Show 6 more

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https://doi.org/10.3390/cancers11111645

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Abstract

Fine needle aspiration cytology (FNAC) is the final diagnosis of thyroid nodules before surgery. It is important to further improve the indeterminate FNAC diagnosis results using computerized cytological features. This retrospective cross-sectional study included 240 cases, of whom 110 had histologic diagnosis of papillary thyroid cancers (PTC), 100 had nodular/adenomatous goiters/hyperplasia (benign goiters), 10 had follicular/Hurthle cell carcinomas, and 20 had follicular adenomas. Morphological and chromatic features of FNAC were quantified and analyzed. The result showed that six quantified cytological features were found significantly different between patients with a histologic diagnosis of PTC and patients with histologic diagnosis of benign goiters in multivariate analysis. These cytological features were used to estimate the malignancy risk in nodules with indeterminate FNAC results. The Area Under the Receiver Operating Characteristics (AUROC) of the diagnostic accuracy with a benign or malignant nature was 81.3% (p < 0.001), 78.7% (p = 0.014), and 56.8% (p = 0.52) for nodules with FNAC results of atypia, which is suspicious for malignancy and follicular neoplasm, respectively. In conclusion, quantification of cytological features could be used to develop a computer-aided tool for diagnosing PTC in thyroid nodules with indeterminate FNAC results.

Highlights

IntroductionThey can be detected in 19%–67% of the normal population using high-resolution sonography, and 5%–15% are malignant [1]
We focused on the cytological features of papillary thyroid cancers (PTC) and the other type of follicular cell-derived thyroid cancers (FCTC), namely, follicular thyroid cancer (FTC), in comparison with those benign follicular cell-derived lesions
Malignant tumors accounted for 13.33%, 57.5%, 31.25%, 94.34%, and 100%, respectively, of the benign, AUS, follicular neoplasm (FN)/suspicious of FN (SFN), suspicious for malignancy (SUSP), and malignant categories on cytological diagnosis

Summary

Introduction

They can be detected in 19%–67% of the normal population using high-resolution sonography, and 5%–15% are malignant [1]. Fine needle aspiration cytology (FNAC) has an essential role in evaluating thyroid nodules before surgery. In samples satisfactory for interpretation, 2%–5% are reported as definitively malignant and 55%–74% as definitively benign [2,3,4,5]. The remaining samples have indeterminate cytology, including atypia of undetermined significance or follicular lesion of undetermined significance (AUS/FLUS) (2%–18%), follicular neoplasm or suspicious for a follicular neoplasm (FN/SFN) (2%–25%), and suspicious for malignancy (SUSP) (1%–6%) [6].

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