The atypia of undetermined significance/follicular lesion of undetermined significance:malignant ratio
- 14 September 2011
- journal article
- research article
- Published by Wiley in Cancer Cytopathology
- Vol. 120 (2), 111-116
- https://doi.org/10.1002/cncy.20192
Abstract
BACKGROUND: The Bethesda System (TBS) for reporting thyroid cytopathology introduced the atypia of undetermined significance/follicular lesion of undetermined significance (AUS) category, but did not provide adequate guidance for the appropriate use of this diagnosis. In the current study, the authors sought to identify an appropriate measure for AUS use based on experience to date with TBS. METHODS: The authors reviewed 8 series, including their own laboratory experiences, with a total of 30,466 thyroid aspirates classified within TBS. RESULTS: The median AUS rate was 9.9% with a range of 3.0% to 18.0%. Use of the individual diagnostic categories within TBS varied up to 12.7‐fold. The ratio of “suspicious for follicular neoplasm” plus “suspicious for malignancy” to “malignant” (M) diagnoses varied the least (1.8‐fold). The AUS:M ratio provided a suitable measure of assessing AUS use, with a median ratio of 2.0 and a range of 0.5 to 4.9. CONCLUSIONS: Based on available studies, an AUS:M ratio of 1.0 to 3.0 is recommended. AUS:M ratios > 3.0 are likely because of overdiagnosis of AUS or underdiagnosis of M. AUS:M ratios < 1.0 are mostly due to low AUS rates, at the likely expense of sensitivity. Cancer (Cancer Cytopathol) 2012;. © 2011 American Cancer Society.Keywords
This publication has 14 references indexed in Scilit:
- Clinical Outcome for Atypia of Undetermined Significance in Thyroid Fine-Needle AspirationsAmerican Journal of Clinical Pathology, 2011
- Diagnostic criteria and risk‐adapted approach to indeterminate thyroid cytodiagnosisCancer Cytopathology, 2010
- Malignancy Risk for Fine-Needle Aspiration of Thyroid Lesions According to The Bethesda System for Reporting Thyroid CytopathologyAmerican Journal of Clinical Pathology, 2010
- Should “atypical follicular cells” in thyroid fine-needle aspirates be subclassified?Cancer Cytopathology, 2010
- Contribution of molecular testing to thyroid fine‐needle aspiration cytology of “follicular lesion of undetermined significance/atypia of undetermined significance”Cancer Cytopathology, 2010
- Fine‐needle aspiration of follicular patterned lesions of the thyroid: Diagnosis, management, and follow‐up according to National Cancer Institute (NCI) recommendationsDiagnostic Cytopathology, 2010
- Evidence‐based evaluation of the risks of malignancy predicted by thyroid fine‐needle aspiration biopsiesDiagnostic Cytopathology, 2009
- The indeterminate thyroid fine‐needle aspirationCancer Cytopathology, 2009
- Implications of the proposed thyroid fine‐needle aspiration category of “follicular lesion of undetermined significance”: A five‐year multi‐institutional analysisDiagnostic Cytopathology, 2009
- Atypical squamous cells of undetermined significance: Interlaboratory comparison and quality assurance monitorsDiagnostic Cytopathology, 1994