TY - JOUR
T1 - Systematic Review and Meta-analysis of the Impact of Noninvasive Follicular Thyroid Neoplasm with Papillary-Like Nuclear Features (NIFTP) on Cytological Diagnosis and Thyroid Cancer Prevalence
AU - Ruanpeng, Darin
AU - Cheungpasitporn, Wisit
AU - Thongprayoon, Charat
AU - Hennessey, James V.
AU - Shrestha, Rupendra T.
PY - 2019/9/15
Y1 - 2019/9/15
N2 - A re-named diagnosis of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) likely impacts the prevalence of thyroid cancer and risk of malignancy in populations based on the established Bethesda System of Reporting Thyroid Cytopathology (TBSRTC). This study was done to investigate the prevalence and cytological distribution of NIFTP. PRISMA guided systematic review was done from a database search of Pubmed, EMBASE, and Medline using the search terms “non-invasive follicular thyroid neoplasm with papillary-like nuclear features”, “non-invasive follicular variant of papillary carcinoma”, “niftp”, and “Bethesda” until November 2018. Original articles with surgically proven diagnoses of NIFTP using strict NIFTP criteria were included. Twenty-nine studies with 1563 cases of NIFTP were included. The pooled prevalence of NIFTP in cases which would be classified previously as the follicular variant of papillary thyroid cancer (FVPTC) and papillary thyroid cancer (PTC) were 43.5% (95% CI 33.5–54.0%) and 4.4% (95% CI 2.0–9.0%) respectively. The pooled TBSRTC distribution of cases diagnosed as NIFTP was: from the non-diagnostic category 3.6% (95% CI 2.4–5.3%), benign 10.0% (95% CI 7.2–13.6%), AUS/FLUS 34.2% (95% CI 28.2–40.8%), FN/SFN 22.7% (95% CI 17.2–29.4%), suspicious for malignancy 22.4% (95% CI 17.7–27.9%), and malignant 7.5% (95% CI 4.2–12.9%). While a significant reduction in FVPTC prevalence is anticipated, a modest reduction of PTC prevalence is also expected with adoption of the NIFTP terminology that would be distributed mainly among lesions classified as indeterminate thyroid nodules. Further studies are needed to identify unique clinical characteristics of these lesions preoperatively.
AB - A re-named diagnosis of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) likely impacts the prevalence of thyroid cancer and risk of malignancy in populations based on the established Bethesda System of Reporting Thyroid Cytopathology (TBSRTC). This study was done to investigate the prevalence and cytological distribution of NIFTP. PRISMA guided systematic review was done from a database search of Pubmed, EMBASE, and Medline using the search terms “non-invasive follicular thyroid neoplasm with papillary-like nuclear features”, “non-invasive follicular variant of papillary carcinoma”, “niftp”, and “Bethesda” until November 2018. Original articles with surgically proven diagnoses of NIFTP using strict NIFTP criteria were included. Twenty-nine studies with 1563 cases of NIFTP were included. The pooled prevalence of NIFTP in cases which would be classified previously as the follicular variant of papillary thyroid cancer (FVPTC) and papillary thyroid cancer (PTC) were 43.5% (95% CI 33.5–54.0%) and 4.4% (95% CI 2.0–9.0%) respectively. The pooled TBSRTC distribution of cases diagnosed as NIFTP was: from the non-diagnostic category 3.6% (95% CI 2.4–5.3%), benign 10.0% (95% CI 7.2–13.6%), AUS/FLUS 34.2% (95% CI 28.2–40.8%), FN/SFN 22.7% (95% CI 17.2–29.4%), suspicious for malignancy 22.4% (95% CI 17.7–27.9%), and malignant 7.5% (95% CI 4.2–12.9%). While a significant reduction in FVPTC prevalence is anticipated, a modest reduction of PTC prevalence is also expected with adoption of the NIFTP terminology that would be distributed mainly among lesions classified as indeterminate thyroid nodules. Further studies are needed to identify unique clinical characteristics of these lesions preoperatively.
KW - Cytology
KW - NIFTP
KW - Non-invasive follicular thyroid neoplasm with papillary-like nuclear features
UR - http://www.scopus.com/inward/record.url?scp=85069538848&partnerID=8YFLogxK
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U2 - 10.1007/s12022-019-09583-4
DO - 10.1007/s12022-019-09583-4
M3 - Article
C2 - 31338752
AN - SCOPUS:85069538848
SN - 1046-3976
VL - 30
SP - 189
EP - 200
JO - Endocrine Pathology
JF - Endocrine Pathology
IS - 3
ER -