TY - JOUR
T1 - Nomogram for predicting malignancy in thyroid nodules using clinical, biochemical, ultrasonographic, and cytologic features
AU - Nixon, Iain J.
AU - Ganly, Ian
AU - Hann, Lucy E.
AU - Lin, Oscar
AU - Yu, Changhong
AU - Brandt, Suzanne
AU - Shah, Jatin P.
AU - Shaha, Ashok
AU - Kattan, Michael W.
AU - Patel, Snehal G.
PY - 2010/1/1
Y1 - 2010/1/1
N2 - Background: Thyroid nodules often discovered incidentally and present a management problem particularly when investigations suggest atypical or suspicious cells. Prediction of the risk of malignancy within such a thyroid nodule is based on clinical, biochemical, ultrasonographic, and cytologic features. Our aim was to create a nomogram to predict accurately the chance of malignancy within a thyroid nodule. Methods: All patients with thyroid nodules who underwent ultrasonographic-guided fine needle aspiration and operative resection at our institution during 2007-2008 were identified. Clinical records, biochemical profiles, pathology reports, ultrasonographic images, and cytology slides were reviewed. A multivariate logistic regression was used to quantify the value of the variables in estimating the risk of malignancy. Results: The records of 158 patients with 190 nodules were reviewed. Eighteen nodules were excluded. The 8 variables with the greatest predictive value selected for the nomogram were biochemical (thyroid-stimulating hormone), ultrasonography (shape, echo texture, and vascularity), and cytology (nuclear grooves, pseudoinclusions, cellularity, and presence of colloid). The nomogram had an excellent predictive accuracy with a concordance index of 91%. Conclusion: We produced a nomogram that can quantify accurately the risk of malignancy in a thyroid nodule based on biochemical, ultrasonographic, and cytologic features.
AB - Background: Thyroid nodules often discovered incidentally and present a management problem particularly when investigations suggest atypical or suspicious cells. Prediction of the risk of malignancy within such a thyroid nodule is based on clinical, biochemical, ultrasonographic, and cytologic features. Our aim was to create a nomogram to predict accurately the chance of malignancy within a thyroid nodule. Methods: All patients with thyroid nodules who underwent ultrasonographic-guided fine needle aspiration and operative resection at our institution during 2007-2008 were identified. Clinical records, biochemical profiles, pathology reports, ultrasonographic images, and cytology slides were reviewed. A multivariate logistic regression was used to quantify the value of the variables in estimating the risk of malignancy. Results: The records of 158 patients with 190 nodules were reviewed. Eighteen nodules were excluded. The 8 variables with the greatest predictive value selected for the nomogram were biochemical (thyroid-stimulating hormone), ultrasonography (shape, echo texture, and vascularity), and cytology (nuclear grooves, pseudoinclusions, cellularity, and presence of colloid). The nomogram had an excellent predictive accuracy with a concordance index of 91%. Conclusion: We produced a nomogram that can quantify accurately the risk of malignancy in a thyroid nodule based on biochemical, ultrasonographic, and cytologic features.
UR - http://www.scopus.com/inward/record.url?scp=78649957236&partnerID=8YFLogxK
U2 - 10.1016/j.surg.2010.09.030
DO - 10.1016/j.surg.2010.09.030
M3 - Article
AN - SCOPUS:78649957236
VL - 148
SP - 1120
EP - 1128
JO - Surgery
JF - Surgery
SN - 0039-6060
IS - 6
ER -