Clinical Decision Making for Surgery using Ultrasound Characteristics of the Thyroid Nodules Classified as Category III (AUS/FLUS) in the Era of Molecular Tests

Bekir Kuru

Department of General Surgery, Ondokuz Mayis University School of Medicine, Turkey

^*Correspondance to: Bekir Kuru 

 PDF  Full Text DOI: 10.25107/2474-1647.1031

Abstract

It has been suggested that they a gene-expression-classifier (GEC) would be worth to be used if there is low suspicion for thyroid cancer in patients with atypia of undetermined significance / follicular lesion of undetermined significance (AUS/FLUS).In our recent study among 153 patients with AUS/FLUS who underwent surgery, malignancy rate for nodules without any worrisome ultrasound features (low suspicion category) was 0%. GEC test had a false negative rate (FNR) of 5.5% for AUS/FLUS patients, and 43% of AUS/FLUS patients have been assumed to be benign on GEC. If GEC was performed on AUS/FLUS patients with low suspicion category (35 patients) in our series, the volume of thyroidectomy would be reduced from 153 to 138 resulting in a 10% decrease with a FNR of 5.5%. If AUS/FLUS nodules with low suspicion category would not have undergone surgery, thyroidectomy volume would be reduced from 153 to 118 resulting in a 23% decrease with a FNR of 0%. These findings show that our approach has apparent advantage over the use of GEC.

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Cite the article

Kuru B. Clinical Decision Making for Surgery using Ultrasound Characteristics of the Thyroid Nodules Classified as Category III (AUS/FLUS) in the Era of Molecular Tests. Clin Surg.2016; 1: 1031.