PDF(Pubmed)
Abstract：
UNASSIGNED: Fine needle aspiration (FNA) biopsy is a widely accepted method for diagnosing thyroid nodules. However, the influence of maximum diameter (MD) of ACR TIRADS 5 (TR5) thyroid nodules on the FNA outcomes remains debated. This study examined the influence of MD on the FNA outcomes and investigated the optimal MD threshold for FNA in TR5 nodules.
UNASSIGNED: We conducted a retrospective analysis of 280 TR5 thyroid nodules from 226 patients who underwent FNA from January to June 2022 in our department. Probably malignant (PM) group was defined as Bethesda V in cytopathology with confirmed BRAF V600E mutation or Bethesda VI, the other cytopathology outcomes were defined as probably benign (PB) group. We examined factors influencing malignant cytopathology outcomes and determined the optimal MD threshold for FNA in TR5 nodules using logistic regression and restricted cubic spline (RCS) analysis.
UNASSIGNED: Among these nodules, 58.2% (163/280) had PM outcomes. The PM group had a significantly larger MD than the PB group [6.5mm (range 5.0-8.4) vs. 5.3mm (range 4.0-7.0), p < 0.001]. In multivariate logistic regression fully adjusted for confounders, MD was significantly associated with PM outcomes [odds ratio 1.16, 95%CI 1.05-1.31; p = 0.042]. The highest quartile of MD had a greater likelihood of PM outcomes compared to the lowest quartile [odds ratio 4.71, 95% CI 1.97-11.69, p = 0.001]. The RCS analysis identified 6.2 mm as the optimal MD threshold for FNA in TR5 nodules.
UNASSIGNED: MD significantly affects the probability of malignant outcomes in FNA of TR5 thyroid nodules. A MD threshold of ≥6.2mm is suggested for FNA in these nodules.
UNASSIGNED: We conducted a retrospective analysis of 280 TR5 thyroid nodules from 226 patients who underwent FNA from January to June 2022 in our department. Probably malignant (PM) group was defined as Bethesda V in cytopathology with confirmed BRAF V600E mutation or Bethesda VI, the other cytopathology outcomes were defined as probably benign (PB) group. We examined factors influencing malignant cytopathology outcomes and determined the optimal MD threshold for FNA in TR5 nodules using logistic regression and restricted cubic spline (RCS) analysis.
UNASSIGNED: Among these nodules, 58.2% (163/280) had PM outcomes. The PM group had a significantly larger MD than the PB group [6.5mm (range 5.0-8.4) vs. 5.3mm (range 4.0-7.0), p < 0.001]. In multivariate logistic regression fully adjusted for confounders, MD was significantly associated with PM outcomes [odds ratio 1.16, 95%CI 1.05-1.31; p = 0.042]. The highest quartile of MD had a greater likelihood of PM outcomes compared to the lowest quartile [odds ratio 4.71, 95% CI 1.97-11.69, p = 0.001]. The RCS analysis identified 6.2 mm as the optimal MD threshold for FNA in TR5 nodules.
UNASSIGNED: MD significantly affects the probability of malignant outcomes in FNA of TR5 thyroid nodules. A MD threshold of ≥6.2mm is suggested for FNA in these nodules.
摘要：
■细针穿刺活检（FNA）是诊断甲状腺结节的一种广泛接受的方法。然而,ACRTIRADS5(TR5)甲状腺结节最大直径(MD)对FNA结局的影响仍存在争议.这项研究检查了MD对FNA结果的影响，并研究了TR5结节中FNA的最佳MD阈值。
■我们对2022年1月至6月在我科接受FNA的226例患者的280个TR5甲状腺结节进行了回顾性分析。可能的恶性（PM）组定义为BethesdaV，在细胞病理学上证实BRAFV600E突变或BethesdaVI，其他细胞病理学结局被定义为可能良性(PB)组.我们检查了影响恶性细胞病理学结果的因素，并使用逻辑回归和限制性三次样条（RCS）分析确定了TR5结节中FNA的最佳MD阈值。
■在这些结节中，58.2%（163/280）有PM结果。PM组的MD明显大于PB组[6.5mm（范围5.0-8.4）与5.3mm（范围4.0-7.0），p<0.001]。在对混杂因素进行完全调整的多元逻辑回归中，MD与PM结果显著相关[比值比1.16，95CI1.05-1.31；p=0.042]。与最低四分位数相比，MD的最高四分位数具有更大的PM结果可能性[比值比4.71，95％CI1.97-11.69，p=0.001]。RCS分析确定6.2mm是TR5结节中FNA的最佳MD阈值。
■MD显著影响TR5甲状腺结节FNA恶性结局的概率。对于这些结节中的FNA，建议MD阈值≥6.2mm。
■我们对2022年1月至6月在我科接受FNA的226例患者的280个TR5甲状腺结节进行了回顾性分析。可能的恶性（PM）组定义为BethesdaV，在细胞病理学上证实BRAFV600E突变或BethesdaVI，其他细胞病理学结局被定义为可能良性(PB)组.我们检查了影响恶性细胞病理学结果的因素，并使用逻辑回归和限制性三次样条（RCS）分析确定了TR5结节中FNA的最佳MD阈值。
■在这些结节中，58.2%（163/280）有PM结果。PM组的MD明显大于PB组[6.5mm（范围5.0-8.4）与5.3mm（范围4.0-7.0），p<0.001]。在对混杂因素进行完全调整的多元逻辑回归中，MD与PM结果显著相关[比值比1.16，95CI1.05-1.31；p=0.042]。与最低四分位数相比，MD的最高四分位数具有更大的PM结果可能性[比值比4.71，95％CI1.97-11.69，p=0.001]。RCS分析确定6.2mm是TR5结节中FNA的最佳MD阈值。
■MD显著影响TR5甲状腺结节FNA恶性结局的概率。对于这些结节中的FNA，建议MD阈值≥6.2mm。
