Abstract: . . .  (100-300 nuovi casi /anno) frequenza simile al mieloma ed al carcinoma dell’esofago della laringe e del collo dell’utero doppia rispetto al m. di Hodgkin Page 9 Nodulo tiroideo – epidemiologia Prevalenza di carcinoma nei nodi non palpabili • Hagag P et al. Thyroid 1998, 8:989–995 – 7/108 (6,4%) nodules > 1 cm • Leenhardt L, JCEM 1999, 84:24–28 – 20/365 (5,4%) • Papini et al. JCEM 2002, 87: 1941–1946, 2002) – Thyroid malignancies were observed in 18 of 195 (9.2%) solitary thyroid nodules and in 13 of 207 (6.3%) multinodular goiters. Cancer prevalence was similar in nodules greater or smaller than 10 mm (9.1 vs. 7.0%). Page 10 Cancro della Tiroide - Epidemiologia Guaribile! • Mortalità 1-1,5/100000 • 0.23% dei decessi per neoplasia Registro Tumori Reg. Piemonte Page 11 Importanza della diagnosi precoce Cancer Res 1991 51(4):1234-41 Survival and causes of death in thyroid cancer: a population-based study of 2479 cases from Norway. Akslen LA, Haldorsen T, Thoresen SO, Glattre E Department of Pathology, Gade Institute, University of Bergen, Norway. Survival and prognostic factors were studied in 2479 clinically presenting thyroid cancers (TC) reported from the entire Norwegian population from 1970 to 1985 . Complete follow-up was obtained (median, 48 months), with information on causes of death. At the end of the observation period, 498 patients were reported to have died of TC , representing 69.7% of all deaths. Among 216 patients dying of other main causes, TC was considered to . . .
. . .  160 FNAB su 3070 259 consecutivi (studio calcificazioni) 104 consecutivi per sospetto clinico 136 Pz. Consec 94 Operati su 450 402 Pz. Consec 155 Nodi solidi 70 Nodi 317 nodi retrospettivo PTP 0,52 0,32 0,19 0,10 0,30 0,29 0,13 0,21 0,08 0,32 0,03 0,12 79 adenomi foll 21 gozzi 9 CMT 13 anapl 4 linfomi 5 k papill 5 k foll 6 CMT 2 k foll 2 CMT GS Page 27 L’ETG della tiroide NODULO CON MICROCALCIFICAZIONI NODULO IPOECOGENO Page 28 Nodo solido, ipoecogeno, margini sfumati Page 29 Nodo prevalentemente ipoecogeno (anecogeno?) Page 30 Nodo solido, isoecogeno: margini netti? alone periferico? microcalcificazioni intranodali… Page 31 Nodo misto! con componente solida > 50 %. margini netti ? alone periferico? microcalcificazioni….. Page 32 Up-to-date della Letteratura PROBLEMI •Caratteri ecografici non sempre facilmente identificabili/oggettivabili •Casistica preselezionata •G old standard non omogeneo Page 33 Two by two table notation for expressing the results of validation study for diagnostic test Result of gold standard test Result of diagnostic test Disease positive (a+c) Disease negative (b+d) Test positive (a+b) True positive (a) False positive (b) Test negative (c+d) False negative (c) True negative (d) (a+c)/(a+b+c+d) Pre-test probability (“Prevalence”) (a+d)/(a+b+c+d) Accuracy (l-sensitivity)/specificity LR- sensitivity/(1-specificity) LR + d/(c+d) Negative predictive value a/(a+b) Positive predictive value d/(b+d) Specificity a/(a+c) Sensitivity Formula Feature Page 34 VPP: probabilità . . .
--3000,2,750,3162,15316