ArticleEndocrine2018
High Ki-67 index in fine needle aspiration cytology of follicular thyroid tumors is associated with increased risk of carcinoma.
Article in Endocrine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Sociodemographic and clinical predictors of malignancy in thyroid nodules: a systematic review and meta-analysis.Frontiers in endocrinology · 2026Pooled it
- Ki67 in endocrine neoplasms: to count or not to count, this is the question! A systematic review from the English language literature.Journal of endocrinological investigation · 2020Pooled it
- [Molecular imaging and biology · 2023Trial
- A case series of ultrasound and pathological assessment of follicular thyroid tumors: Addressing indeterminate malignancy.Medicine · 2025Article
- Prediction of Follicular Thyroid Neoplasm and Malignancy of Follicular Thyroid Neoplasm Using Multiparametric MRI.Journal of imaging informatics in medicine · 2024Article
- Clinical and Paraclinical Considerations Regarding ki67's Role in the Management of Differentiated Thyroid Carcinoma-A Literature Review.Medicina (Kaunas, Lithuania) · 2024Review
- Circulating small extracellular vesicle-based miRNA classifier for follicular thyroid carcinoma: a diagnostic study.British journal of cancer · 2024Article
- Immunohistochemistry in the pathologic diagnosis and management of thyroid neoplasms.Frontiers in endocrinology · 2023Review
- Prognostic Utility of the Ki-67 Labeling Index in Follicular Thyroid Tumors: a 20-Year Experience from a Tertiary Thyroid Center.Endocrine pathology · 2022Article
- Can We Predict Differentiated Thyroid Cancer Behavior? Role of Genetic and Molecular Markers.Medicina (Kaunas, Lithuania) · 2021Review
- Analysis of the association of BRAFV600E mutation and Ki-67 overexpression with clinical and pathological characteristics in papillary thyroid cancer.Radiation and environmental biophysics · 2021Article
- Challenges in Cytology Specimens With Hürthle Cells.Frontiers in endocrinology · 2021Review
- Value of Ultrasound Combined with Immunohistochemistry Evaluation of Central Lymph Node Metastasis for the Prognosis of Papillary Thyroid Carcinoma.Cancer management and research · 2020Article
- Approach the Invasive Potential with Hurthle Cell Tumors of Thyroid.Pathology oncology research : POR · 2019Article
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8 authors.
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No grant is acknowledged in the PubMed record.
Abstract
purposePreoperative distinction of follicular thyroid carcinoma (FTC) from follicular thyroid adenoma (FTA) is a diagnostic challenge. Our aim was to investigate whether the Ki-67 proliferation index in fine needle aspiration material can contribute to the diagnosis of FTC.
methodsWe analyzed retrospectively cytological Ki-67 index determined in routine clinical setting and clinical data for 61 patients with FTC, 158 patients with FTA and 15 patients with follicular tumor of uncertain malignant potential (FT-UMP) surgically treated and diagnosed by histopathology at Karolinska University Hospital 2006-2017 (Cohort A). A previously published cohort of 109 patients with follicular tumors was re-analyzed as well (Cohort B).
resultsIn Cohort A, patients with FTC had a higher Ki-67 index (p < 0.001), larger tumor size (p < 0.001) and higher age at diagnosis (p = 0.036) compared to patients with FTA or FT-UMP. Hürthle cell differentiation, present in 50 FTA, 20 FTC and 8 FT-UMP, was associated with higher Ki-67 index (p = 0.009). Multivariate analysis of Cohort A identified a high Ki-67 index (odds ratio [OR]: 1.215, p < 0.001) and large tumor size (OR: 1.038, p < 0.001) as independent predictors of FTC. Results remained consistent after exclusion of Hürthle cell tumors and in pooled analysis of Cohort A + B. The area under curve of the Ki-67 index for predicting FTC was 0.722 and a cut-off for Ki-67 index at above 5% resulted in a specificity at 93% and sensitivity at 31%. Subgroup analysis of FTCs in Cohort A showed an association of higher Ki-67 index to extrathyroidal extension (p = 0.001) as well as widely invasive subtype (p = 0.019) based on the WHO 2017 classification.
conclusionsPre-operative Ki-67 index may add diagnostic information for a subset of patients with follicular thyroid tumors.
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