Are the anatomical, clinical, and ultrasound characteristics of thyroid nodules with Bethesda III or IV cytology and ACR TI-RADS 3, 4, or 5 able to refine the indications for molecular diagnostic tests?

• Autor(a) principal: Gustavo Cancela e Penna
• Data de Publicação: 2021
• Outros Autores: Camila Teixeira Costa, Magda Carvalho Pires, Tarcizo Afonso Nunes
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UFMG
• Texto Completo: https://doi.org/10.20945/2359-3997000000402; http://hdl.handle.net/1843/52612; https://orcid.org/0000-0003-2125-7051; https://orcid.org/0000-0003-3227-1799; https://orcid.org/0000-0003-3312-4002; https://orcid.org/0000-0001-7971-5786
• topic: Thyroid nodules; Indeterminate nodules; Indeterminate thyroid nodules; Molecular tests; Molecular diagnostic tests; Nódulo da glândula tireoide; Técnicas de diagnóstico molecular; Neoplasias

Objective: To analyze the association of clinical, anatomical, and ultrasound (US) characteristics of malignancies in Bethesda III or IV (III-B or IV-B) thyroid nodules. Subjects and methods: The association between malignancies and the following variables were analyzed: III-B or IV-B, age < 55 years and ≥ 55 years, sex, family history of thyroid cancer, history of irradiation, nodule size, and ACR TI-RADS classification in 62 participants who underwent thyroidectomy. Results: Of the 62 participants, 87.1% (54/62) were women, 74.2% were < 55 years old, 95.2% had no family history of thyroid cancer, 56.5% had nodules < 2 cm in size, 62.9% were IV-B, and 69.4% were ACR TI-RADS 4. Thirty-two patients had thyroid carcinoma, and 30 had benign histology. Among all factors associated with malignancy, only ACR TI-RADS 5 classification on US was found to be statistically significant (p = 0.014), while III-B with architectural atypia cytological classification was the only one significantly associated with benign status (p = 0.004). Conclusion: Only a high risk of malignancy as assessed using US was able to refine the indication for molecular tests in a group of patients with indeterminate nodules. We found 85% (53/62) of III-B or IV-B thyroid nodules would benefit from available molecular diagnostic tests.