American College of Radiology–Developed Thyroid Imaging Reporting and Data System 3, 4, and 5 thyroid nodules are distinctive by cytology, genetic imprints, and histology

IF 3.2 3区医学 Q3 ONCOLOGY

Cancer Cytopathology Pub Date : 2025-09-29 DOI:10.1002/cncy.70050

Sanhong Yu MD, PhD, Minhua Wang MD, PhD, Jonathan Langdon MD, PhD, Jessica Zhao MD, Sara I. Pai MD, PhD, John Sinard MD, PhD, Guoping Cai MD, Manju L. Prasad MD, Adebowale J. Adeniran MD

{"title":"American College of Radiology–Developed Thyroid Imaging Reporting and Data System 3, 4, and 5 thyroid nodules are distinctive by cytology, genetic imprints, and histology","authors":"Sanhong Yu MD, PhD, Minhua Wang MD, PhD, Jonathan Langdon MD, PhD, Jessica Zhao MD, Sara I. Pai MD, PhD, John Sinard MD, PhD, Guoping Cai MD, Manju L. Prasad MD, Adebowale J. Adeniran MD","doi":"10.1002/cncy.70050","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Thyroid nodules, found in up to 68% of adults, can be risk-stratified by high-resolution ultrasound. This study evaluates the concordance between “suspicious” Thyroid Imaging Reporting and Data System (TI-RADS) 3–5 nodules and cytologic and molecular findings from fine-needle aspiration.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A total of 1199 suspicious thyroid nodules stratified as TI-RADS 3 (<i>n</i> = 384), TI-RADS 4 (<i>n</i> = 569), and TI-RADS 5 (<i>n</i> = 246) were studied. Cytopathologic and molecular results were correlated with clinical data from electronic medical records.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Cytology, histology, and molecular testing revealed a lower risk of malignancy in TI-RADS 3 and 4 nodules compared to TI-RADS 5. Among TI-RADS 3 nodules, 75% (287 of 384) were cytologically benign, with only one case diagnosed as papillary thyroid carcinoma (PTC), and 8 of 48 resected nodules (17%) confirmed as carcinoma. In TI-RADS 4, 10% (56 of 569) were suspicious for or diagnosed as PTC by cytology, with 85 of 130 (65%) resected nodules confirmed as carcinoma. In TI-RADS 5, 44% (109 of 246) were cytologically suspicious for or diagnosed as PTC, and 129 of 154 (84%) resected nodules were malignant. High-risk mutations were more frequent in TI-RADS 5 than in TI-RADS 3 and 4. Overall malignancy rates were 2.0% (eight of 384) for TI-RADS 3, 14% (77 of 569) for TI-RADS 4, and 52% (129 of 246) for TI-RADS 5 nodules.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>TI-RADS 3, 4, and 5 nodules demonstrate distinct cytologic, molecular, and histologic features. TI-RADS 3 and 4 nodules are associated with lower malignancy risks, whereas TI-RADS 5 nodules exhibit a high risk of malignancy and are associated with higher mortality.</p>\n </section>\n </div>","PeriodicalId":9410,"journal":{"name":"Cancer Cytopathology","volume":"133 10","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cancer Cytopathology","FirstCategoryId":"3","ListUrlMain":"https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncy.70050","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Thyroid nodules, found in up to 68% of adults, can be risk-stratified by high-resolution ultrasound. This study evaluates the concordance between “suspicious” Thyroid Imaging Reporting and Data System (TI-RADS) 3–5 nodules and cytologic and molecular findings from fine-needle aspiration.

Methods

A total of 1199 suspicious thyroid nodules stratified as TI-RADS 3 (n = 384), TI-RADS 4 (n = 569), and TI-RADS 5 (n = 246) were studied. Cytopathologic and molecular results were correlated with clinical data from electronic medical records.

Results

Cytology, histology, and molecular testing revealed a lower risk of malignancy in TI-RADS 3 and 4 nodules compared to TI-RADS 5. Among TI-RADS 3 nodules, 75% (287 of 384) were cytologically benign, with only one case diagnosed as papillary thyroid carcinoma (PTC), and 8 of 48 resected nodules (17%) confirmed as carcinoma. In TI-RADS 4, 10% (56 of 569) were suspicious for or diagnosed as PTC by cytology, with 85 of 130 (65%) resected nodules confirmed as carcinoma. In TI-RADS 5, 44% (109 of 246) were cytologically suspicious for or diagnosed as PTC, and 129 of 154 (84%) resected nodules were malignant. High-risk mutations were more frequent in TI-RADS 5 than in TI-RADS 3 and 4. Overall malignancy rates were 2.0% (eight of 384) for TI-RADS 3, 14% (77 of 569) for TI-RADS 4, and 52% (129 of 246) for TI-RADS 5 nodules.

Conclusion

TI-RADS 3, 4, and 5 nodules demonstrate distinct cytologic, molecular, and histologic features. TI-RADS 3 and 4 nodules are associated with lower malignancy risks, whereas TI-RADS 5 nodules exhibit a high risk of malignancy and are associated with higher mortality.

Abstract Image

查看原文本刊更多论文

美国放射学会开发的甲状腺成像报告和数据系统3,4,5甲状腺结节在细胞学，遗传印记和组织学上是独特的。

背景：高分辨率超声可对高达68%的成人甲状腺结节进行风险分层。本研究评估了“可疑”甲状腺影像学报告和数据系统（TI-RADS） 3-5结节与细针穿刺细胞学和分子检查结果之间的一致性。方法：对1199例可疑甲状腺结节进行TI-RADS 3（384例）、TI-RADS 4（569例）、TI-RADS 5（246例）分层分析。细胞病理和分子结果与电子病历的临床数据相关。结果：细胞学、组织学和分子检测显示，与TI-RADS 5相比，TI-RADS 3和4结节的恶性风险较低。在384例TI-RADS 3结节中，75%（287例）为细胞学良性，其中只有1例诊断为甲状腺乳头状癌（PTC）， 48例切除结节中有8例（17%）确诊为癌。在TI-RADS中，10%（569例中有56例）被细胞学怀疑或诊断为PTC， 130例切除结节中有85例（65%）被确诊为癌。在TI-RADS 5中，44%（246例中有109例）的细胞学可疑或诊断为PTC， 154例中有129例（84%）的切除结节为恶性结节。高危突变在TI-RADS 5中比在TI-RADS 3和4中更常见。TI-RADS 3的总恶性率为2.0%（384例中有8例），TI-RADS 4的总恶性率为14%（569例中有77例），TI-RADS 5结节的总恶性率为52%（246例中有129例）。结论：TI-RADS 3、4和5结节表现出不同的细胞学、分子和组织学特征。TI-RADS 3和4型结节与较低的恶性风险相关，而TI-RADS 5型结节表现出较高的恶性风险，并与较高的死亡率相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Cancer Cytopathology 医学-病理学

CiteScore

7.00

自引率

17.60%

发文量

130

审稿时长

1 months

期刊介绍： Cancer Cytopathology provides a unique forum for interaction and dissemination of original research and educational information relevant to the practice of cytopathology and its related oncologic disciplines. The journal strives to have a positive effect on cancer prevention, early detection, diagnosis, and cure by the publication of high-quality content. The mission of Cancer Cytopathology is to present and inform readers of new applications, technological advances, cutting-edge research, novel applications of molecular techniques, and relevant review articles related to cytopathology.