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Low Elasticity of Thyroid Nodules on Ultrasound Elastography Is Correlated with Malignancy, Degree of Fibrosis, and High Expression of Galectin-3 and Fibronectin-1.
- Source :
-
Thyroid : official journal of the American Thyroid Association [Thyroid] 2017 Jan; Vol. 27 (1), pp. 103-110. Date of Electronic Publication: 2016 Dec 21. - Publication Year :
- 2017
-
Abstract
- Background: Thyroid ultrasound (US) elastography provides an estimation of tissue stiffness and is helpful to differentiate malignant from benign lesions. Tissue proprieties and molecules causing stiffness are not established. The aim of the study was to correlate US elastography findings with tissue properties in thyroid nodules.<br />Methods: A total of 115 thyroid nodules from 112 patients who underwent surgery for the presence of Thy 3 (indeterminate) cytology (n = 67), Thy 4-5 (suspicious-indicative of carcinoma) cytology (n = 47), or large goiter in the presence of Thy 2 cytology (n = 1) and suspicious US features were examined by US elastography. Tissues obtained after surgery were characterized for cell number, microvessel density, fibrosis, and expression of galectin-3 (Gal-3) and fibronectin-1 (FN-1).<br />Results: Low elasticity on qualitative US elastography (LoEl) was found in 66 nodules (one benign and 65 carcinomas); high elasticity (HiEl) was found in 49 nodules (46 benign and three carcinomas; p < 0.0001). Quantitative analysis, performed in 24 nodules and expressed as elastic ratio between the strain of the nodule and that of the surrounding thyroid parenchyma, showed a mean of 1.90 (interquartile range [IQR] 1.18-2.77) in 14 nodules with LoEl, and a mean of 1.01 (IQR 0.91-1.10) in 10 nodules with HiEl (p = 0.002). Stiffness did not correlate with cell number and was inversely correlated with microvessel density. Fibrosis was higher in nodules with LoEl than in those with HiEl (p = 0.009) and in carcinomas than in benign nodules (p = 0.02). Fibrosis was higher in nodules with high expression of Gal-3 (p < 0.001) and FN-1 (p = 0.004). Fibrosis and expression of Gal-3 and FN-1 were higher in the classic compared with the follicular variant of papillary thyroid carcinoma and lower in follicular adenomas.<br />Conclusions: Low elasticity at US elastography is highly correlated with malignancy. Nodule stiffness is correlated with fibrosis and expression of Gal-3 and FN-1. These features are more evident in the classic than in the follicular variant of papillary thyroid carcinoma.
- Subjects :
- Adenoma metabolism
Adenoma pathology
Adult
Carcinoma metabolism
Carcinoma pathology
Diagnosis, Differential
Elasticity
Female
Fibrosis diagnostic imaging
Fibrosis metabolism
Fibrosis pathology
Humans
Male
Middle Aged
Thyroid Neoplasms metabolism
Thyroid Neoplasms pathology
Thyroid Nodule metabolism
Thyroid Nodule pathology
Adenoma diagnostic imaging
Carcinoma diagnostic imaging
Elasticity Imaging Techniques
Fibronectins metabolism
Galectin 3 metabolism
Thyroid Neoplasms diagnostic imaging
Thyroid Nodule diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1557-9077
- Volume :
- 27
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Thyroid : official journal of the American Thyroid Association
- Publication Type :
- Academic Journal
- Accession number :
- 27809694
- Full Text :
- https://doi.org/10.1089/thy.2016.0341