Preoperative cytologic morphometry may assist in predicting patient outcome after surgery in papillary thyroid cancer.
OBJECTIVE
To evaluate the quantitative estimations of various cytologic nuclear features on smears obtained by preoperative fine-needle aspiration and to examine their correlation with patient outcome after surgery for papillary thyroid cancer.


METHODS
The subjects consisted of 142 patients with common type papillary thyroid cancer. The aspirated smears were examined quantitatively with a standard microscope connected to a computerized video system, and the mean nuclear area, nuclear perimeter, form factor (FF) and the coefficient of variation of the nuclear area (NACV) were measured and calculated. All of the surgically treated patients were followed through serial clinical evaluations, and correlations between the cytologic parameters and patient outcomes were analyzed.


RESULTS
Local relapses or distant metastases were identified in 13 (9.2%) of the 142 patients in the median follow-up period of 160 (range, 108-234) months. Recurred cases had higher FF values than disease-free cases (p = 0.0017), especially in local relapse (p = 0.0015). Distant metastases were frequently observed in the cases with a high NACV value (p = 0.0020).


CONCLUSIONS
Preoperative quantitative estimations of cytologic nuclear features provide preoperative clinical information that may predict patient outcome and be useful for designing individual protocols.
Nagashima
Takeshi
T
Department of General Surgery and Clinical Pathology, Chiba University Graduate School of Medicine, Chiba, Japan. nagasima-cib@umin.ac.jp
Sakakibara
Masahiro
M
Nakatani
Yukio
Y
Miyazaki
Masaru
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002291:Carcinoma, Papillary / Q000473:pathology* / Q000601:surgery; D048430:Cell Shape; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000473:pathology; D012372:ROC Curve; D012008:Recurrence; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome