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":"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。","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":"{\"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}","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}
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
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.
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.
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