The risk of malignancy in uterine polyps: A systematic review and meta-analysis

Author(s):  
Anna Uglietti ◽  
Laura Buggio ◽  
Marilena Farella ◽  
Francesca Chiaffarino ◽  
Dhouha Dridi ◽  
...  
2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Else Marie Aarstad ◽  
Petter Nordhaug ◽  
Mohammad Naghavi-Behzad ◽  
Lisbet Brønsro Larsen ◽  
Oke Gerke ◽  
...  

Abstract Background FDG-PET/CT is increasingly used for oncologic and inflammatory diseases. Focal incidental FDG uptake occurs rarely in breast tissue but has often significant consequences. This study aimed to systematically review literature regarding focal incidental breast uptake (FIBU) on FDG-PET/CT in order to yield an update on the prevalence and risk of malignancy for FIBU. Methods A systematic search for relevant articles published between 2012 and 2018 was performed through MEDLINE, Embase, and Cochrane databases. Studies addressing the detection of FIBU in patients without a previous history of breast malignancy were included. The QUADAS-2 was used for quality assessment, and eligible data were pooled using a fixed-effects model. I2 was calculated for the heterogeneity between studies. Results Eight studies containing 180,002 scans were included in the systematic review. The median prevalence of FIBU for both genders was 0.52% (range 0.18–22.5%). Prevalence for women was mentioned separately in five studies and varied from 0.51 to 23.5%. One study reporting a high prevalence was based on patients being staged for known malignancy, and the word “breast” was used in the search, which may have caused selection bias. Data from four studies were eligible for meta-analysis. A high degree of heterogeneity was observed for prevalence data (I2 of 97.5%), while moderate heterogeneity was observed for data on malignancy risk assessment (I2 of 62.8%). The pooled prevalence of FIBU in women was 0.61% (range 0.56–0.66%), and the pooled prevalence of malignancy of FIBUs was 38.7% (range 34.4–43.0%). The most commonly detected malignancy was invasive ductal carcinoma. Conclusion FIBU occurs rarely on FDG-PET/CT for female patients but yields a high risk of malignancy according to the results of published papers. Therefore, it should be considered relevant to further elucidate patients with incidentally detected FDG uptake in breast in clinical practice.


Pancreatology ◽  
2016 ◽  
Vol 16 (3) ◽  
pp. S77
Author(s):  
Giovanni Taffurelli ◽  
Claudio Ricci ◽  
Donatella Santini ◽  
Davide Campana ◽  
Valentina Ambrosini ◽  
...  

Author(s):  
Laura Buggio ◽  
Dhouha Dridi ◽  
Maria Pina Frattaruolo ◽  
Marco Reschini ◽  
Eugenia Di Loreto ◽  
...  

2014 ◽  
Vol 170 (5) ◽  
pp. R203-R211 ◽  
Author(s):  
Paolo Campanella ◽  
Francesca Ianni ◽  
Carlo Antonio Rota ◽  
Salvatore Maria Corsello ◽  
Alfredo Pontecorvi

ObjectiveIn order to quantify the risk of malignancy of clinical and ultrasonographic features of thyroid nodules (TNs), we did a systematic review and meta-analysis of published studies.MethodsWe did a literature search in MEDLINE for studies published from 1st January 1989 until 31st December 2012. Studies were considered eligible if they investigated the association between at least one clinical/ultrasonographic feature and the risk of malignancy, did not have exclusion criteria for the detected nodules, had histologically confirmed the diagnoses of malignancy, and had a univariable analysis available. Two reviewers independently extracted data on study characteristics and outcomes.ResultsThe meta-analysis included 41 studies, for a total of 29 678 TN. A higher risk of malignancy expressed in odds ratio (OR) was found for the following: nodule height greater than width (OR: 10.15), absent halo sign (OR: 7.14), microcalcifications (OR: 6.76), irregular margins (OR: 6.12), hypoechogenicity (OR: 5.07), solid nodule structure (OR: 4.69), intranodular vascularization (OR: 3.76), family history of thyroid carcinoma (OR: 2.29), nodule size ≥4 cm (OR: 1.63), single nodule (OR: 1.43), history of head/neck irradiation (OR: 1.29), and male gender (OR: 1.22).Interestingly, meta-regression analysis showed a higher risk of malignancy for hypoechoic nodules in iodine-sufficient than in iodine-deficient geographical areas.ConclusionsThe current meta-analysis verified and weighed out each suspicious clinical and ultrasonographic TN feature. The highest risk was found for nodule height greater than width, absent halo sign, and microcalcifications for ultrasonographic features and family history of thyroid carcinoma for clinical features. A meta-analysis-derived grading system of TN malignancy risk, validated on a large prospective cohort, could be a useful tool in TN diagnostic work-up.


2019 ◽  
Vol 181 (4) ◽  
pp. 389-396 ◽  
Author(s):  
Massimo Bongiovanni ◽  
William C Faquin ◽  
Luca Giovanella ◽  
Cosimo Durante ◽  
Peter Kopp ◽  
...  

Objective The second version of The Bethesda System for Reporting Thyroid Cytopathology endorsed the introduction of non-invasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP) as a distinct entity with low malignant potential into clinical practice. Consequently, the risk of malignancy (ROM) of cytological diagnoses has changed, but the magnitude of the change remains uncertain. The present systematic review was undertaken to obtain more robust information about the true impact of NIFTP on the ROM among patients undergoing surgery following a fine-needle aspiration cytology (FNAC) diagnosis of suspicious for malignancy (Bethesda V) or malignant (Bethesda VI). As they are managed surgically, these two diagnostic categories are the primary entities that are clinically impacted by the advent of NIFTP. Design Systematic review and meta-analysis. Methods A comprehensive literature search of online databases was performed in November 2018. The search was conducted looking for data of histologically proven NIFTP with preoperative FNAC. Results One-hundred fifty-seven articles were identified and nine were included in the study. Overall, there were 13,752 thyroidectomies with a cancer prevalence of 45.7%. When NIFTP was considered non-malignant, the pooled risk difference for ROM was 5.5%. Applying meta-analysis, the pooled prevalence of NIFTP among nodules with FNAC of Bethesda V or Bethesda VI was 14 and 3%, respectively. Conclusion This meta-analysis shows that the inclusion of NIFTP leads to a reduction in the ROM for the Bethesda V and Bethesda VI FNAC diagnostic categories by 14 and 3%, respectively. Clinicians should be aware of these data to avoid overtreatment.


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