Comparison of risk of malignancy in a subgroup with atypia of undetermined significance/follicular lesion of undetermined significance: A meta-analysis

Head Neck. 2017 Aug;39(8):1699-1710. doi: 10.1002/hed.24768. Epub 2017 May 11.

Abstract

Background: As heterogeneous findings are included in the atypia of undetermined significance (AUS)/follicular lesion of undetermined significance (FLUS) category, differing risks of malignancy in subgroups have been reported in several articles.

Methods: We performed a meta-analysis of full-text publications written in English found in the Embase and PubMed databases.

Results: The 4-tiered subgroup proportion meta-analysis showed that the 95% confidence interval (95% CI) of the risk of malignancy in the cellular atypia group did not overlap with the other 3 subgroups and demonstrated a significant difference. Two-tiered analysis using the cytologic and architectural atypia groups showed that cytologic atypia group had a 2.64-fold increase in the risk of malignancy compared with the architectural atypia group.

Conclusion: The cytologic atypia had a significantly higher risk of malignancy than the architectural atypia group, and it should be considered as a separate category.

Keywords: atypia of undetermined significance; biopsy; fine-needle; meta-analysis; neoplasm; thyroid nodule.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Biopsy
  • Confidence Intervals
  • Cytodiagnosis
  • Diagnosis, Differential
  • Humans
  • Thyroid Diseases / pathology*
  • Thyroid Gland / pathology*
  • Thyroid Neoplasms / pathology*
  • Thyroid Nodule / pathology