Abstract：
BACKGROUND: The aim of our study is to determine the value of Thyroid Imaging Reporting and Data Systems (TIRADS) scoring in predicting malignancy in thyroid nodules by examining its relationship with fine needle aspiration biopsy and postoperative histopathological results.
METHODS: In this study, patients who underwent surgery after ultrasonographic examination and fine needle aspiration biopsy for thyroid nodules at the General Surgery Clinic of Çukurova University Faculty of Medicine between January 2014 and November 2021 were retrospectively analyzed. The thyroid ultrasonography and fine needle aspiration biopsy of the included patients were performed by a clinician with 15 years of experience. The ultrasonographic features of the nodules were re-evaluated by the same clinician, and the American College of Radiology (ACR) TIRADS score was determined. Fine needle aspiration biopsy results were grouped according to Bethesda criteria. Postoperative histopathological examination results were divided into two groups: benign and malignant. The ACR TIRADS score was compared with fine needle aspiration biopsy and histopathological results. The performance of the ACR TIRADS score in predicting malignancy was determined.
RESULTS: 79.8% of the 397 patients were female, and the mean age was 50.9 ± 12.8 years. The mean diameter of the nodules was 27.4 ± 15.8 mm. There was a significant, positive, but weak correlation between ACR TIRADS and Bethesda (p < 0.001) (r = 0.33). When the ACR TIRADS score was compared with histopathological results, it was found that the rate of malignancy increased as the TIRADS score increased (p < 0.001). The rates of malignancy diagnosis were 0% for TR1, 13.2% for TR2, 21.7% for TR3, 50.3% for TR4, and 72.4% for TR5. The area under the receiver operating characteristic curve for TIRADS in predicting malignancy was 0.747 (95% CI: 0.699-0.796, p < 0.001). TIRADS can distinguish malignancy with 75% accuracy. The optimal cutoff point was determined as TR4 with 80.3% sensitivity and 60.8% specificity.
CONCLUSIONS: The ACR TIRADS scoring system is an effective risk classification system for thyroid nodules, providing 75% accuracy in predicting malignancy, with 80.3% sensitivity and 60.8% specificity values.
METHODS: In this study, patients who underwent surgery after ultrasonographic examination and fine needle aspiration biopsy for thyroid nodules at the General Surgery Clinic of Çukurova University Faculty of Medicine between January 2014 and November 2021 were retrospectively analyzed. The thyroid ultrasonography and fine needle aspiration biopsy of the included patients were performed by a clinician with 15 years of experience. The ultrasonographic features of the nodules were re-evaluated by the same clinician, and the American College of Radiology (ACR) TIRADS score was determined. Fine needle aspiration biopsy results were grouped according to Bethesda criteria. Postoperative histopathological examination results were divided into two groups: benign and malignant. The ACR TIRADS score was compared with fine needle aspiration biopsy and histopathological results. The performance of the ACR TIRADS score in predicting malignancy was determined.
RESULTS: 79.8% of the 397 patients were female, and the mean age was 50.9 ± 12.8 years. The mean diameter of the nodules was 27.4 ± 15.8 mm. There was a significant, positive, but weak correlation between ACR TIRADS and Bethesda (p < 0.001) (r = 0.33). When the ACR TIRADS score was compared with histopathological results, it was found that the rate of malignancy increased as the TIRADS score increased (p < 0.001). The rates of malignancy diagnosis were 0% for TR1, 13.2% for TR2, 21.7% for TR3, 50.3% for TR4, and 72.4% for TR5. The area under the receiver operating characteristic curve for TIRADS in predicting malignancy was 0.747 (95% CI: 0.699-0.796, p < 0.001). TIRADS can distinguish malignancy with 75% accuracy. The optimal cutoff point was determined as TR4 with 80.3% sensitivity and 60.8% specificity.
CONCLUSIONS: The ACR TIRADS scoring system is an effective risk classification system for thyroid nodules, providing 75% accuracy in predicting malignancy, with 80.3% sensitivity and 60.8% specificity values.
摘要：
背景：我们研究的目的是通过检查甲状腺成像报告和数据系统（TIRADS）评分与细针穿刺活检和术后组织病理学结果的关系，确定其在预测甲状腺结节恶性程度中的价值。
方法：在本研究中，回顾性分析2014年1月至2021年11月在阿库库罗瓦大学医学院普外科诊所接受超声检查和甲状腺结节细针穿刺活检后接受手术的患者.纳入患者的甲状腺超声检查和细针穿刺活检由具有15年经验的临床医生进行。由同一临床医生重新评估结节的超声特征，并确定了美国放射学会（ACR）TIRADS评分。细针穿刺活检结果根据Bethesda标准进行分组。术后病理组织学检查结果分为良、恶性两组。将ACRTIRADS评分与细针穿刺活检和组织病理学结果进行比较。确定ACRTIRADS评分在预测恶性肿瘤方面的表现。
结果：397例患者中79.8%为女性，平均年龄为50.9±12.8岁。结节的平均直径为27.4±15.8mm。有一个重要的，积极的,但ACRTIRDS与Bethesda之间的相关性较弱（p<0.001）（r=0.33）。当ACRTIRADS评分与组织病理学结果进行比较时，发现恶性肿瘤的发生率随着TIRADS评分的增加而增加(p<0.001).TR1的恶性肿瘤诊断率为0％，TR2为13.2％，TR3为21.7％，TR4为50.3％，TR5为72.4％。TIRADS预测恶性肿瘤的受试者工作特征曲线下面积为0.747（95％CI：0.699-0.796，p<0.001）。TIRADS可以区分恶性肿瘤，准确率为75％。最佳截止点被确定为TR4,具有80.3%的灵敏度和60.8%的特异性。
结论：ACRTIRADS评分系统是甲状腺结节的有效风险分类系统，在预测恶性肿瘤方面提供75%的准确率，敏感性为80.3%，特异性为60.8%。
方法：在本研究中，回顾性分析2014年1月至2021年11月在阿库库罗瓦大学医学院普外科诊所接受超声检查和甲状腺结节细针穿刺活检后接受手术的患者.纳入患者的甲状腺超声检查和细针穿刺活检由具有15年经验的临床医生进行。由同一临床医生重新评估结节的超声特征，并确定了美国放射学会（ACR）TIRADS评分。细针穿刺活检结果根据Bethesda标准进行分组。术后病理组织学检查结果分为良、恶性两组。将ACRTIRADS评分与细针穿刺活检和组织病理学结果进行比较。确定ACRTIRADS评分在预测恶性肿瘤方面的表现。
结果：397例患者中79.8%为女性，平均年龄为50.9±12.8岁。结节的平均直径为27.4±15.8mm。有一个重要的，积极的,但ACRTIRDS与Bethesda之间的相关性较弱（p<0.001）（r=0.33）。当ACRTIRADS评分与组织病理学结果进行比较时，发现恶性肿瘤的发生率随着TIRADS评分的增加而增加(p<0.001).TR1的恶性肿瘤诊断率为0％，TR2为13.2％，TR3为21.7％，TR4为50.3％，TR5为72.4％。TIRADS预测恶性肿瘤的受试者工作特征曲线下面积为0.747（95％CI：0.699-0.796，p<0.001）。TIRADS可以区分恶性肿瘤，准确率为75％。最佳截止点被确定为TR4,具有80.3%的灵敏度和60.8%的特异性。
结论：ACRTIRADS评分系统是甲状腺结节的有效风险分类系统，在预测恶性肿瘤方面提供75%的准确率，敏感性为80.3%，特异性为60.8%。
