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Purpose: Indeterminate cytology still puzzles clinicians, due to its wide range of oncological risks. According to the Italian SIAPEC-IAP classification, TIR3B cytology holds up to 30% of thyroid cancer, which justifies the surgical indication, even if more than half of cases do not result in a positive histology. The study aim is to identify potential clinical, ultrasound or cytological features able to improve the surgical indication.

Methods: Retrospective analysis. A consecutive series of TIR3B nodules referred to the Endocrine Unit of Careggi Hospital from 1st May 2014 to 31st December 2021 was considered for the exploratory analysis (Phase 1). Thereafter, a smaller confirmatory sample of consecutive TIR3B diagnosed and referred to surgery from 1st January 2022 to 31st June 2022 was considered to verify the algorithm (Phase 2). The main clinical, ultrasound and cytological features have been collected. A comprehensive stepwise logistic regression was applied to build a prediction algorithm. The histological results represented the final outcome.

Results: Of 599 TIR3B nodules referred to surgery, 451 cases were included in the exploratory analysis. A final score > 14.5 corresponded to an OR = 4.98 (95% CI 3.24-7.65, p < 0.0001) and showed a PPV and NPV of 57% and 79%, respectively. The Phase 2 analysis on a confirmatory sample of 58 TIR3B cytology confirmed that a threshold of 14.5 points has a comparable PPV and NPV of 53% and 80%, respectively.

Conclusions: A predictive algorithm which considers the main clinical, US and cytological features can significantly improve the oncological stratification of TIR3B cytology.

Titel:	Improving the TIR3B oncological stratification: try to bridge the gap through a comprehensive presurgical algorithm.
Autor/in / Beteiligte Person:	Sparano, C ; Puccioni, M ; Adornato, V ; Zago, E ; Fibbi, B ; Badii, B ; Bencini, L ; Mannelli, G ; Vezzosi, V ; Maggi, M ; Petrone, L
Link:	Full Text Finder (Volltext)
Zeitschrift:	Journal of endocrinological investigation, Jg. 47 (2024-03-01), Heft 3, S. 633-643
Veröffentlichung:	2014- : Berlin : Springer ; <i>Original Publication</i>: Milano, Published for the Italian Society of Endocrinology by Editrice Kurtis., 2024
Medientyp:	academicJournal
ISSN:	1720-8386 (electronic)
DOI:	10.1007/s40618-023-02182-5
Schlagwort:	Humans Retrospective Studies Hospitals Medical Oncology Algorithms Thyroid Neoplasms
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [J Endocrinol Invest] 2024 Mar; Vol. 47 (3), pp. 633-643. <i>Date of Electronic Publication: </i>2023 Sep 22. MeSH Terms: Algorithms* ; Thyroid Neoplasms* ; Humans ; Retrospective Studies ; Hospitals ; Medical Oncology References: Nardi F, Basolo F, Crescenzi A et al (2014) Italian consensus for the classification and reporting of thyroid cytology. J Endocrinol Invest 37:593–599. https://doi.org/10.1007/s40618-014-0062-0. (PMID: 10.1007/s40618-014-0062-024789536) ; Cibas ES, Ali SZ (2017) The 2017 bethesda system for reporting thyroid cytopathology. Thyroid 27:1341–1346. https://doi.org/10.1089/thy.2017.0500. (PMID: 10.1089/thy.2017.050029091573) ; Sparano C, Verdiani V, Pupilli C et al (2021) Choosing the best algorithm among five thyroid nodule ultrasound scores: from performance to cytology sparing-a single-center retrospective study in a large cohort. 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Improving the TIR3B oncological stratification: try to bridge the gap through a comprehensive presurgical algorithm.