From the Department of Surgery (Alqahtani), from ther Department of Community Medicine and Public Health (Mahmood), College of Medicine, Majmaah University, Al-Majmaah; from the Department of Surgery (Alanesi, Alharthi, Alzahrani, Alalawi), from the Department of Radiodiagnostics and Medical Imaging (Moustafa), from the Department of Pathology (Moharram), King Salman Armed Forces Hospital Northwestern Region, Tabuk, Kingdom of Saudi Arabia, and from Azra Naheed Medical College (Mahmood), Superior University, Lahore, Pakistan.
Saudi Med J. 2022 May;43(5):473-478. doi: 10.15537/smj.2022.43.5.20220045.
To estimate the risk of malignancy in indeterminate thyroid nodules and to determine whether certain clinical or radiological parameters can predict the risk of malignancy.
This retrospective study enrolled all adult patients (age ≥14 years) with a cytological diagnosis of atypia/follicular lesion of undetermined significance and follicular neoplasm/suspicious for a follicular neoplasm between January 2014 and January 2020. Fifty patients with surgically treated primary thyroid nodules, documented final histological diagnosis, and ultrasound examination records were included. Thyroid nodules were evaluated radiologically using Thyroid Imaging Reporting and Data System introduced by the American College of Radiology (2017).
Forty-two (84.0%) female and 8 (16.0%) male patients were enrolled in the study. The malignancy risks were 44.8% for Bethesda III and 28.6% for Bethesda IV. The malignancy risks for the Thyroid Imaging Reporting and Data System categories were 33.3% (TR2), 39.1% (TR3), 35.3% (TR4), and 50% (TR5). No significant associations were observed between age, gender, Bethesda category, and Thyroid Imaging Reporting and Data System and the risk of malignancy.
None of the clinical or radiological characteristics evaluated in this study contributed to the cancer risk stratification of thyroid nodules with indeterminate cytology. A prospective multicenter study is needed to better understand cytologically indeterminate thyroid nodules.
评估不典型甲状腺结节的恶性风险,并确定某些临床或影像学参数是否可以预测恶性风险。
本回顾性研究纳入了 2014 年 1 月至 2020 年 1 月期间所有经细胞学诊断为不典型/滤泡性病变意义不明和滤泡性肿瘤/滤泡性肿瘤可疑的成年患者(年龄≥14 岁)。共纳入 50 例接受手术治疗的原发性甲状腺结节患者,记录最终组织学诊断和超声检查记录。甲状腺结节采用美国放射学院(2017 年)引入的甲状腺影像报告和数据系统进行影像学评估。
本研究纳入了 42 名(84.0%)女性和 8 名(16.0%)男性患者。Bethesda III 的恶性风险为 44.8%,Bethesda IV 的恶性风险为 28.6%。甲状腺影像报告和数据系统分类的恶性风险分别为 33.3%(TR2)、39.1%(TR3)、35.3%(TR4)和 50%(TR5)。年龄、性别、Bethesda 分类和甲状腺影像报告和数据系统与恶性风险之间未观察到显著相关性。
本研究评估的临床或影像学特征均不能对细胞学不典型的甲状腺结节的癌症风险分层。需要进行前瞻性多中心研究以更好地了解细胞学不典型的甲状腺结节。