Ping-Chia Cheng1, Chih-Ming Chang1,2, Li-Jen Liao1,3,4, Po-Wen Cheng1, Wu-Chia Lo1. 1. Department of Otolaryngology Head and Neck Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.). 2. Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan (R.O.C.). 3. Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan (R.O.C.). 4. Medical Engineering Office, Far Eastern Memorial Hospital, New Taipei City, Taiwan (R.O.C.).
Abstract
OBJECTIVES: This study aims to propose a cytological classification, to evaluate predictive factors of the final malignancy, and to suggest a proper management strategy for neck lymph nodes (LNs) with indeterminate cytology. METHODS: Patients who had neck lymphadenopathy with indeterminate cytology between 2007 and 2017 were analyzed retrospectively in a tertiary medical center. Cytological classification was conducted according to the cytological descriptions. We examined the clinical characteristics according to the final diagnosis of the neck lymphadenopathy. RESULTS: According to the final diagnoses, there were 142 malignant and 95 benign neck LNs among 237 patients. Multivariate analyses using a stepwise logistic regression model showed that cytological classification [p < 0.001, OR = 5.67 (3.48-9.23)], prior history of malignancy [p = 0.01, OR = 2.97 (1.26-6.99)], long axis [p = 0.01, OR = 3.06 (1.33-7.06)], short-to-long axis (S/L) ratio [p = 0.047, OR = 2.15 (1.01-4.57)] and internal echogenicity [p = 0.01, OR = 2.72 (1.26-5.86)] were independent predictors of malignancy. CONCLUSIONS: In patients who have neck LNs with indeterminate cytology, a cytological classification and four other predictors (prior history of malignancy, long axis ≥ 1.93 cm, S/L ratio ≥ 0.64 and heterogeneity of internal echogenicity) are statistically associated with the risk of malignancy and helpful in guiding further management.
OBJECTIVES: This study aims to propose a cytological classification, to evaluate predictive factors of the final malignancy, and to suggest a proper management strategy for neck lymph nodes (LNs) with indeterminate cytology. METHODS:Patients who hadneck lymphadenopathy with indeterminate cytology between 2007 and 2017 were analyzed retrospectively in a tertiary medical center. Cytological classification was conducted according to the cytological descriptions. We examined the clinical characteristics according to the final diagnosis of the neck lymphadenopathy. RESULTS: According to the final diagnoses, there were 142 malignant and 95 benign neck LNs among 237 patients. Multivariate analyses using a stepwise logistic regression model showed that cytological classification [p < 0.001, OR = 5.67 (3.48-9.23)], prior history of malignancy [p = 0.01, OR = 2.97 (1.26-6.99)], long axis [p = 0.01, OR = 3.06 (1.33-7.06)], short-to-long axis (S/L) ratio [p = 0.047, OR = 2.15 (1.01-4.57)] and internal echogenicity [p = 0.01, OR = 2.72 (1.26-5.86)] were independent predictors of malignancy. CONCLUSIONS: In patients who have neck LNs with indeterminate cytology, a cytological classification and four other predictors (prior history of malignancy, long axis ≥ 1.93 cm, S/L ratio ≥ 0.64 and heterogeneity of internal echogenicity) are statistically associated with the risk of malignancy and helpful in guiding further management.
Authors: Bryan R Haugen; Erik K Alexander; Keith C Bible; Gerard M Doherty; Susan J Mandel; Yuri E Nikiforov; Furio Pacini; Gregory W Randolph; Anna M Sawka; Martin Schlumberger; Kathryn G Schuff; Steven I Sherman; Julie Ann Sosa; David L Steward; R Michael Tuttle; Leonard Wartofsky Journal: Thyroid Date: 2016-01 Impact factor: 6.568