Ulisse Salvatore, Bosco Daniela, Nardi Francesco, Nesca Angela, D'Armiento Eleonora, Guglielmino Valeria, De Vito Corrado, Sorrenti Salvatore, Pironi Daniele, Tartaglia Francesco, Arcieri Stefano, Catania Antonio, Monti Massimo, Filippini Angelo, Ascoli Valeria
Department of Surgical Sciences, "Sapienza" University of Rome, 00161 Rome, Italy.
Department of Radiological, Oncological and Anatomo-Pathological Sciences, "Sapienza" University of Rome, 00161 Rome, Italy.
Int J Endocrinol. 2017;2017:9692304. doi: 10.1155/2017/9692304. Epub 2017 Mar 1.
The new Italian cytological classification (2014) of thyroid nodules replaced the TIR3 category of the old classification (2007) with two subclasses, TIR3A and TIR3B, with the aim of reducing the rate of surgery for benign diseases. Moreover, thyroid imaging reporting and data system (TI-RADS) score appears to ameliorate the stratification of the malignancy risk. We evaluated whether the new Italian classification has improved diagnostic accuracy and whether its association with TI-RADS score could improve malignancy prediction. We retrospectively analyzed 70 nodules from 70 patients classified as TIR3 according to the old Italian classification who underwent surgery for histological diagnosis. Of these, 51 were available for cytological revision according to the new Italian cytological classification. Risk of malignancy was determined for TIR3A and TIR3B, TI-RADS score, and their combination. A different rate of malignancy ( = 0.0286) between TIR3A (13.04%) and TIR3B (44.44%) was observed. Also TI-RADS score is significantly ( = 0.003) associated with malignancy. By combining cytology and TI-RADS score, patients could be divided into three groups with low (8.3%), intermediate (21.4%), and high (80%) risk of malignancy. In conclusion, the new Italian cytological classification has an improved diagnostic accuracy. Interestingly, the combination of cytology and TI-RADS score offers a better stratification of the malignancy risk.
意大利甲状腺结节新的细胞学分类（2014年）用两个亚类TIR3A和TIR3B取代了旧分类（2007年）中的TIR3类别，目的是降低良性疾病的手术率。此外，甲状腺影像报告和数据系统（TI-RADS）评分似乎改善了恶性风险分层。我们评估了意大利新分类是否提高了诊断准确性，以及其与TI-RADS评分的联合是否能改善恶性预测。我们回顾性分析了70例根据旧意大利分类被归类为TIR3并接受手术进行组织学诊断的患者的70个结节。其中，51个结节可根据意大利新的细胞学分类进行细胞学复查。确定了TIR3A和TIR3B、TI-RADS评分及其联合的恶性风险。观察到TIR3A（13.04%）和TIR3B（44.44%）之间存在不同的恶性率（=0.0286）。TI-RADS评分也与恶性肿瘤显著相关（=0.003）。通过结合细胞学和TI-RADS评分，患者可分为恶性风险低（8.3%）、中（21.4%）和高（80%）三组。总之，意大利新的细胞学分类提高了诊断准确性。有趣的是，细胞学和TI-RADS评分的联合能更好地对恶性风险进行分层。
