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Outcomes of repeat fineneedle aspiration biopsy for AUS/FLUS thyroid nodules.
European Journal of Endocrinology ( IF 5.8 ) Pub Date : 2021-08-27 , DOI: 10.1530/eje-21-0330 Ane Bayona 1 , Patricia Benavent 1 , Alfonso Muriel 2 , Cesar Abuchaibe 3 , Susan C Sharpe 4 , Valentina Tarasova 5 , Bryan McIver 5 , Pablo Valderrabano 1
European Journal of Endocrinology ( IF 5.8 ) Pub Date : 2021-08-27 , DOI: 10.1530/eje-21-0330 Ane Bayona 1 , Patricia Benavent 1 , Alfonso Muriel 2 , Cesar Abuchaibe 3 , Susan C Sharpe 4 , Valentina Tarasova 5 , Bryan McIver 5 , Pablo Valderrabano 1
Affiliation
OBJECTIVE
To determine the proportion of aspirates reclassified into each Bethesda category and to assess the rates of malignancy in each of them on repeat fine-needle aspiration biopsy (RFNA) following an AUS/FLUS diagnosis.
DESIGN
Systematic review and meta-analysis.
METHODS
On February 2019, Pubmed/MEDLINE, EMBASE, WoS, and the Cochrane Library were searched for articles published from January 1, 2007. All studies published in English describing RFNA outcomes in AUS/FLUS nodules were included. PRISMA and MOOSE guidelines were followed. Five investigators independently assessed the eligibility of the studies. Two investigators extracted summary data and assessed the risk of bias. Data were pooled using a random-effects model. The rate of malignancy was calculated on resected nodules only (upper limit of true value); and considering all unresected nodules were benign (lower limit of true value). The protocol was registered in PROSPERO (CRD42019123114).
RESULTS
Of 2937 retrieved studies, 27 were eligible. The meta-analysis was conducted on summary data of 3932 AUS/FLUS thyroid nodules with RFNA. RFNA cytology would reclassify into categories I through VI of Bethesda: 4% (3%, 5%), 48% (43%, 54%), 26% (20%, 32%), 4% (3%, 6%), 5% (3%, 6%), and 2% (1%, 2%) of AUS/FLUS nodules. Malignancy rates of resected nodules were 24% (9%, 38%), 4% (1%, 7%), 40% (28%, 52%), 37% (27%, 47%), 79% (69%, 90%), and 99% (95%, 100%) for categories I through VI of Bethesda. There was high heterogeneity in these data.
CONCLUSIONS
RFNA reclassified two-thirds of the AUS/FLUS specimens into a more definitive cytological category, with a benign call rate of nearly 50% and a negative predictive value greater than 96%.
中文翻译:
AUS/FLUS 甲状腺结节重复细针穿刺活检的结果。
目的 确定重新分类到每个 Bethesda 类别的抽吸物的比例,并评估 AUS/FLUS 诊断后重复细针抽吸活检 (RFNA) 中每种抽吸物的恶性率。设计系统回顾和荟萃分析。方法 2019 年 2 月,在 Pubmed/MEDLINE、EMBASE、WoS 和 Cochrane Library 中搜索了自 2007 年 1 月 1 日以来发表的文章。所有以英文发表的描述 AUS/FLUS 结节 RFNA 结果的研究都包括在内。遵循 PRISMA 和 MOOSE 指南。五名研究者独立评估了研究的资格。两名研究人员提取了汇总数据并评估了偏倚风险。使用随机效应模型汇总数据。仅根据切除的结节计算恶性率(真值上限);并且考虑到所有未切除的结节都是良性的(真实值的下限)。该协议已在 PROSPERO (CRD42019123114) 中注册。结果 在检索到的 2937 项研究中,有 27 项符合条件。该荟萃分析是对 3932 个 AUS/FLUS 甲状腺结节和 RFNA 的汇总数据进行的。RFNA 细胞学将重新分类为 Bethesda 的 I 至 VI 类:4% (3%, 5%), 48% (43%, 54%), 26% (20%, 32%), 4% (3%, 6%) )、5% (3%, 6%) 和 2% (1%, 2%) 的 AUS/FLUS 结节。切除结节的恶性率分别为 24%(9%、38%)、4%(1%、7%)、40%(28%、52%)、37%(27%、47%)、79%(69 %, 90%) 和 99% (95%, 100%) 用于 Bethesda 的 I 至 VI 类。这些数据存在高度异质性。结论 RFNA 将三分之二的 AUS/FLUS 标本重新分类为更明确的细胞学类别,
更新日期:2021-07-01
中文翻译:
AUS/FLUS 甲状腺结节重复细针穿刺活检的结果。
目的 确定重新分类到每个 Bethesda 类别的抽吸物的比例,并评估 AUS/FLUS 诊断后重复细针抽吸活检 (RFNA) 中每种抽吸物的恶性率。设计系统回顾和荟萃分析。方法 2019 年 2 月,在 Pubmed/MEDLINE、EMBASE、WoS 和 Cochrane Library 中搜索了自 2007 年 1 月 1 日以来发表的文章。所有以英文发表的描述 AUS/FLUS 结节 RFNA 结果的研究都包括在内。遵循 PRISMA 和 MOOSE 指南。五名研究者独立评估了研究的资格。两名研究人员提取了汇总数据并评估了偏倚风险。使用随机效应模型汇总数据。仅根据切除的结节计算恶性率(真值上限);并且考虑到所有未切除的结节都是良性的(真实值的下限)。该协议已在 PROSPERO (CRD42019123114) 中注册。结果 在检索到的 2937 项研究中,有 27 项符合条件。该荟萃分析是对 3932 个 AUS/FLUS 甲状腺结节和 RFNA 的汇总数据进行的。RFNA 细胞学将重新分类为 Bethesda 的 I 至 VI 类:4% (3%, 5%), 48% (43%, 54%), 26% (20%, 32%), 4% (3%, 6%) )、5% (3%, 6%) 和 2% (1%, 2%) 的 AUS/FLUS 结节。切除结节的恶性率分别为 24%(9%、38%)、4%(1%、7%)、40%(28%、52%)、37%(27%、47%)、79%(69 %, 90%) 和 99% (95%, 100%) 用于 Bethesda 的 I 至 VI 类。这些数据存在高度异质性。结论 RFNA 将三分之二的 AUS/FLUS 标本重新分类为更明确的细胞学类别,