Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200011, China.
Department of Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
J Cancer Res Clin Oncol. 2024 Jun 25;150(6):327. doi: 10.1007/s00432-024-05847-7.
Beyond the Thyroid Imaging Reporting and Data System (TIRADS) classification of thyroid nodules, additional factors must be weighed in the decision to perform fine needle aspiration (FNA). In this study, we aimed to identify risk factors for malignancy in patients with ultrasound-classified Chinese-TIRADS (C-TIRADS) 4 A nodules.
Patients who underwent thyroid FNA at our institution between May 2021 and September 2022 were enrolled. We collected demographic data, including age, sex, previous radiation exposure, and family history. An in-person questionnaire was used to collect lifestyle data, such as smoking habits and alcohol consumption. Body mass index (BMI) was calculated. The serum levels of thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TGAb) were measured. Prior to FNA, ultrasonic inspection reports were reviewed. The cytologic diagnoses for FNA of thyroid nodules followed the Bethesda System for Reporting Thyroid Cytopathology (2017).
Among the 252 C-TIRADS 4 A nodules, 103 were malignant. Compared to those in the benign group, the patients in the malignant group had a younger age (42.2 ± 13.6 vs. 51.5 ± 14.0 years, P < 0.001). Logistic regression showed that advanced age was associated with a lower risk of malignancy in C-TIRADS 4 A nodules (OR = 0.95, 95% CI 0.93 ~ 0.97, P < 0.001). We demonstrated a decreased risk of malignancy in patients with 48.5 years or older.
Advanced age was associated with a decreased risk of malignancy in patients with C-TIRADS 4 A nodules. This study indicated that in addition to sonographic characteristics, patient age should be considered when assessing the risk of malignancy.
除了甲状腺影像报告和数据系统（TIRADS）对甲状腺结节的分类外，在决定进行细针抽吸（FNA）时还必须考虑其他因素。在本研究中，我们旨在确定超声分类为中国 TIRADS（C-TIRADS）4A 结节的患者发生恶性肿瘤的风险因素。
本研究纳入了 2021 年 5 月至 2022 年 9 月在我院接受甲状腺 FNA 的患者。我们收集了人口统计学数据，包括年龄、性别、既往辐射暴露和家族史。使用面对面问卷收集生活方式数据，如吸烟习惯和饮酒情况。计算体重指数（BMI）。测量血清促甲状腺激素（TSH）、甲状腺过氧化物酶抗体（TPOAb）和甲状腺球蛋白抗体（TGAb）水平。在 FNA 之前，回顾了超声检查报告。甲状腺细针抽吸细胞学诊断遵循 2017 年甲状腺细胞病理学报告的 Bethesda 系统（Bethesda System for Reporting Thyroid Cytopathology）。
在 252 个 C-TIRADS 4A 结节中，有 103 个为恶性。与良性组相比，恶性组患者年龄较小（42.2±13.6 岁比 51.5±14.0 岁，P<0.001）。Logistic 回归显示，年龄较大与 C-TIRADS 4A 结节恶性程度较低相关（OR=0.95，95%CI 0.93~0.97，P<0.001）。我们发现，年龄 48.5 岁或以上的患者恶性肿瘤的风险降低。
年龄较大与 C-TIRADS 4A 结节患者的恶性肿瘤风险降低相关。本研究表明，除了超声特征外，在评估恶性肿瘤风险时还应考虑患者年龄。
