ACR TI-RADS评分结合细胞病理学分级可改善不确定甲状腺结节的风险分层。

IF 2.5 Q3 ENDOCRINOLOGY & METABOLISM Minerva endocrinology Pub Date : 2023-04-06 DOI:10.23736/S2724-6507.22.03929-X
Francesco Feroci, Davina Perini, Alessio Giordano, Luca Romoli, Tommaso Guagni, Angela Coppola, Iacopo Giani, Serenella Checchi, Alvaro Petrucci, Antonio Sarno, Stefano Cantafio
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引用次数: 0

摘要

背景:本回顾性研究的目的是阐述一种新的诊断模型,该模型将细胞学报告(2017 Bethesda系统报告甲状腺细胞病理学)与超声特征(基于ACR TI-RADS评分)相结合,以实现对不确定甲状腺结节恶性风险的更准确定义。方法:将90例行甲状腺切除术的患者分为低危(AUS/流感合并TI-RADS 2/TI-RADS 3, FN/SFN合并TI-RADS 2)、中度危(AUS/流感合并TI-RADS 4/TI-RADS 5, FN/SFN合并TI-RADS 3/TI-RADS 4)、高危(FN/SFN合并TI-RADS 5)三类。高危患者(81.82%)应推荐手术入路,中危患者(25.42%)应仔细评估,而低危患者(0.00%)可采用保守入路。结论:在cell - us评分中整合这两个多参数系统已被证明是实现更准确的恶性肿瘤风险定义的可行和可靠的帮助。
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ACR TI-RADS Score combined with cytopathology classification improves the risk stratification of indeterminate thyroid nodules.

Background: The aim of this retrospective study was the elaboration of a new diagnostic model that integrate cytological reports (2017 Bethesda System for Reporting Thyroid Cytopathology) with ultrasonographic features (based on ACR TI-RADS score) to achieve a more accurate definition of indeterminate thyroid nodule malignancy risk.

Methods: Ninety patients submitted to thyroidectomy were divided in three classes: low malignancy risk (AUS/FLUS with TI-RADS 2/TI-RADS 3 and FN/SFN with TI-RADS 2), intermediate malignancy risk (AUS/FLUS with TI-RADS 4/TI-RADS 5 and FN/SFN with TI-RADS 3/TI-RADS 4), and high malignancy risk (FN/SFN with TI-RADS 5).

Results: The surgical approach should be recommended in high-risk patients (81.82% of malignancies), carefully evaluated in intermediate risk (25.42%), whereas a conservative approach can be adopted in low-risk patients (0.00%).

Conclusions: The integration of these two multiparametric systems in a Cyto-US score has proven to be a feasible and reliable aid to achieve a more accurate definition of malignancy risk.

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