Abstract
Thyroid cancer can be detected in 5-10% of patients with thyroid nodules. Management may be a challenge if fine-needle aspiration biopsy yields Bethesda III findings. Most of these cases undergo surgery and are ultimately found benign. Our aim was to evaluate whether serum osteopontin can accurately estimate thyroid cancer risk in cases with cytologically Bethesda III thyroid nodules and, thereby, decrease the number of unnecessary surgical interventions. We obtained blood samples of cases with repeated cytologically Bethesda III thyroid nodules before surgery, and followed up the pathology results after thyroidectomy. We evaluated serum osteopontin from 36 patients with papillary thyroid cancer and compared them with 40 benign cases. Serum osteopontin levels in patients with papillary thyroid cancer are significantly higher than in benign cases (mean serum osteopontin: 10.48 ± 3.51 ng/mL vs6.14 ± 2.29 ng/mL, P < 0.001). The area under the receiver operating characteristics curve was 0.851, suggesting that serum osteopontin could have considerable discriminative performance. In our preliminary study, high serum osteopontin levels can predict the risk of papillary thyroid cancer in thyroid nodules with Bethesda III cytology. Further studies are necessary to confirm these findings.
Highlights
Thyroid cancer is the most common cancer of the endocrine system, with a continuously increasing incidence in the last decades (Pellegriti et al 2013)
Thyroid nodules are initially examined by fine-needle aspiration biopsy (FNAB), but the frequent indeterminate or suspicious FNAB results are challenging in terms of defining an appropriate management strategy (Poller & Kandaswamy 2013)
We aimed to investigate the diagnostic and clinical role of serum osteopontin levels in patients who underwent thyroid surgery due to cytologic results repeatedly showing AUS
Summary
Thyroid cancer is the most common cancer of the endocrine system, with a continuously increasing incidence in the last decades (Pellegriti et al 2013). Usually benign, are detected in up to 2–6% of patients on physical exam, 19–68% of patients on ultrasound, and 8–65% on autopsy (Dean & Gharib 2008). Thyroid nodules are initially examined by fine-needle aspiration biopsy (FNAB), but the frequent indeterminate or suspicious FNAB results are challenging in terms of defining an appropriate management strategy (Poller & Kandaswamy 2013). When thyroid nodule cytologic results show follicular lesions of undetermined significance or atypia of undetermined significance (FLUS/AUS, Bethesda III), the results are often called indeterminate, and the risk of malignancy reaches
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