Abstract：
OBJECTIVE: The aim of this study was to evaluate the diagnostic value of four commonly utilized ultrasound (US) RSSs, namely, the American College of Radiology [ACR], European [EU], Korean [K] TI-RADSs and American Thyroid Association [ATA] US-based RSS criteria, in combination with activating point mutations of the RAS genes (NRAS, HRAS, and KRAS) for detection of thyroid carcinoma in cytologically indeterminate and suspicious for malignancy thyroid nodules.
METHODS: We retrospectively analyzed cytologically indeterminate and suspicious for malignancy thyroid nodules which underwent US, molecular testing and surgery between September 1, 2018, and December 31, 2023. Receiver operating characteristic (ROC) curves were generated, and the area under the curve (AUC, 95% confidence interval [CI]) was calculated.
RESULTS: A total of 100 cytologically indeterminate and 24 suspicious for malignancy thyroid nodules were analyzed. Compared to the four US-based RSSs alone, the diagnostic value of the four US-based RSSs combined with RAS mutations did not significantly improved (cytologically indeterminate, AUC [95% CI] 0.6 [0.5-0.7] and 0.6 [0.5-0.7], respectively, p = 0.70; cytologically suspicious for malignancy, AUC [95% CI] 0.7 [0.5-0.9] and 0.8 [0.6-0.9], respectively, p = 0.23).
CONCLUSIONS: The diagnostic value of the four main US-based RSSs (ACR, EU, K, and ATA) was not improved in conjunction with the evaluation of RAS mutations for preoperative risk stratification of cytologically indeterminate thyroid nodules.
CONCLUSIONS: In cytologically indeterminate nodules categorized according to US-based RSSs, isolated RAS positivity does not reliably distinguish between benignity and malignancy.
METHODS: We retrospectively analyzed cytologically indeterminate and suspicious for malignancy thyroid nodules which underwent US, molecular testing and surgery between September 1, 2018, and December 31, 2023. Receiver operating characteristic (ROC) curves were generated, and the area under the curve (AUC, 95% confidence interval [CI]) was calculated.
RESULTS: A total of 100 cytologically indeterminate and 24 suspicious for malignancy thyroid nodules were analyzed. Compared to the four US-based RSSs alone, the diagnostic value of the four US-based RSSs combined with RAS mutations did not significantly improved (cytologically indeterminate, AUC [95% CI] 0.6 [0.5-0.7] and 0.6 [0.5-0.7], respectively, p = 0.70; cytologically suspicious for malignancy, AUC [95% CI] 0.7 [0.5-0.9] and 0.8 [0.6-0.9], respectively, p = 0.23).
CONCLUSIONS: The diagnostic value of the four main US-based RSSs (ACR, EU, K, and ATA) was not improved in conjunction with the evaluation of RAS mutations for preoperative risk stratification of cytologically indeterminate thyroid nodules.
CONCLUSIONS: In cytologically indeterminate nodules categorized according to US-based RSSs, isolated RAS positivity does not reliably distinguish between benignity and malignancy.
摘要：
目的：本研究的目的是评估四种常用超声（US）RS的诊断价值，即,美国放射学院[ACR]，欧洲[欧盟]，韩国[K]TI-RADS和美国甲状腺协会[ATA]基于美国的RSS标准，结合RAS基因的激活点突变(NRAS，HRAS,和KRAS）用于检测细胞学不确定且可疑为恶性甲状腺结节的甲状腺癌。
方法：我们回顾性分析了细胞学不确定和可疑的恶性甲状腺结节，2018年9月1日至2023年12月31日之间的分子检测和手术。产生受试者工作特征(ROC)曲线,和曲线下面积(AUC，计算95%置信区间[CI])。
结果：共分析了100个细胞学不确定和24个可疑为恶性甲状腺结节。仅与美国的四个RSS相比，结合RAS突变的四个基于US的RSSs的诊断价值没有显着改善（细胞学上不确定，AUC[95%CI]0.6[0.5-0.7]和0.6[0.5-0.7]，分别,p=0.70；细胞学可疑恶性肿瘤，AUC[95%CI]0.7[0.5-0.9]和0.8[0.6-0.9]，分别,p=0.23）。
结论：四种主要的基于US的RS的诊断价值（ACR，欧盟,K,和ATA）与RAS突变评估在细胞学上不确定的甲状腺结节的术前风险分层中没有改善。
结论：在根据基于美国的RSS分类的细胞学上不确定的结节中，孤立的RAS阳性不能可靠地区分良性和恶性。
方法：我们回顾性分析了细胞学不确定和可疑的恶性甲状腺结节，2018年9月1日至2023年12月31日之间的分子检测和手术。产生受试者工作特征(ROC)曲线,和曲线下面积(AUC，计算95%置信区间[CI])。
结果：共分析了100个细胞学不确定和24个可疑为恶性甲状腺结节。仅与美国的四个RSS相比，结合RAS突变的四个基于US的RSSs的诊断价值没有显着改善（细胞学上不确定，AUC[95%CI]0.6[0.5-0.7]和0.6[0.5-0.7]，分别,p=0.70；细胞学可疑恶性肿瘤，AUC[95%CI]0.7[0.5-0.9]和0.8[0.6-0.9]，分别,p=0.23）。
结论：四种主要的基于US的RS的诊断价值（ACR，欧盟,K,和ATA）与RAS突变评估在细胞学上不确定的甲状腺结节的术前风险分层中没有改善。
结论：在根据基于美国的RSS分类的细胞学上不确定的结节中，孤立的RAS阳性不能可靠地区分良性和恶性。
