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Endocrine Pathology

, Volume 30, Issue 3, pp 189–200 | Cite as

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

  • Darin Ruanpeng
  • Wisit Cheungpasitporn
  • Charat Thongprayoon
  • James V. Hennessey
  • Rupendra T. ShresthaEmail author
Article
  • 81 Downloads

Abstract

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.

Keywords

NIFTP Non-invasive follicular thyroid neoplasm with papillary-like nuclear features Cytology 

Notes

Author Contributions

Conceptualization and methodology, D.R. and R.T.S.; Software and formal analysis, W. C and C.T.; data curation, D.R., R.T.S, W.C., C.T.; writing—original draft preparation, D.R. and R.T.S; writing—review and editing R.T.S, J.V.H, W.C., C. T.; supervision: RTS.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Supplementary material

12022_2019_9583_MOESM1_ESM.docx (1.1 mb)
ESM 1 (DOCX 1156 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of MedicineUniversity MinnesotaMinneapolisUSA
  2. 2.Department of MedicineUniversity of Mississippi Medical CenterMississippiUSA
  3. 3.Department of MedicineMayo ClinicRochesterUSA
  4. 4.Department of EndocrinologyBeth Israel Deaconess Medical CenterBoston, GZ-6USA

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