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Abstract：
OBJECTIVE: Beyond the Thyroid Imaging Reporting and Data System (TIRADS) classification of thyroid nodules, additional factors must be weighed in the decision to perform fine needle aspiration (FNA). In this study, we aimed to identify risk factors for malignancy in patients with ultrasound-classified Chinese-TIRADS (C-TIRADS) 4 A nodules.
METHODS: Patients who underwent thyroid FNA at our institution between May 2021 and September 2022 were enrolled. We collected demographic data, including age, sex, previous radiation exposure, and family history. An in-person questionnaire was used to collect lifestyle data, such as smoking habits and alcohol consumption. Body mass index (BMI) was calculated. The serum levels of thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TGAb) were measured. Prior to FNA, ultrasonic inspection reports were reviewed. The cytologic diagnoses for FNA of thyroid nodules followed the Bethesda System for Reporting Thyroid Cytopathology (2017).
RESULTS: Among the 252 C-TIRADS 4 A nodules, 103 were malignant. Compared to those in the benign group, the patients in the malignant group had a younger age (42.2 ± 13.6 vs. 51.5 ± 14.0 years, P < 0.001). Logistic regression showed that advanced age was associated with a lower risk of malignancy in C-TIRADS 4 A nodules (OR = 0.95, 95% CI 0.93 ~ 0.97, P < 0.001). We demonstrated a decreased risk of malignancy in patients with 48.5 years or older.
CONCLUSIONS: Advanced age was associated with a decreased risk of malignancy in patients with C-TIRADS 4 A nodules. This study indicated that in addition to sonographic characteristics, patient age should be considered when assessing the risk of malignancy.
METHODS: Patients who underwent thyroid FNA at our institution between May 2021 and September 2022 were enrolled. We collected demographic data, including age, sex, previous radiation exposure, and family history. An in-person questionnaire was used to collect lifestyle data, such as smoking habits and alcohol consumption. Body mass index (BMI) was calculated. The serum levels of thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TGAb) were measured. Prior to FNA, ultrasonic inspection reports were reviewed. The cytologic diagnoses for FNA of thyroid nodules followed the Bethesda System for Reporting Thyroid Cytopathology (2017).
RESULTS: Among the 252 C-TIRADS 4 A nodules, 103 were malignant. Compared to those in the benign group, the patients in the malignant group had a younger age (42.2 ± 13.6 vs. 51.5 ± 14.0 years, P < 0.001). Logistic regression showed that advanced age was associated with a lower risk of malignancy in C-TIRADS 4 A nodules (OR = 0.95, 95% CI 0.93 ~ 0.97, P < 0.001). We demonstrated a decreased risk of malignancy in patients with 48.5 years or older.
CONCLUSIONS: Advanced age was associated with a decreased risk of malignancy in patients with C-TIRADS 4 A nodules. This study indicated that in addition to sonographic characteristics, patient age should be considered when assessing the risk of malignancy.
摘要：
目的：除了甲状腺影像报告和数据系统（TIRADS）分类以外，在决定进行细针抽吸术(FNA)时,必须权衡其他因素.在这项研究中,我们旨在确定超声分类的Chinese-TIRADS(C-TIRADS)4A结节患者的恶性肿瘤危险因素.
方法：纳入2021年5月至2022年9月在我们机构接受甲状腺FNA的患者。我们收集了人口统计数据,包括年龄,性别,以前的辐射暴露，和家族史。使用当面问卷收集生活方式数据，例如吸烟习惯和饮酒。计算体重指数(BMI)。血清促甲状腺激素(TSH)水平,甲状腺过氧化物酶抗体(TPOAb),测量甲状腺球蛋白抗体（TGAb）。在FNA之前，超声检查报告进行了审查。甲状腺结节FNA的细胞学诊断遵循Bethesda甲状腺细胞病理学报告系统（2017年）。
结果：在252个C-TIRADS4A结节中，103是恶性的。与良性组相比，恶性组患者年龄较小(42.2±13.6vs.51.5±14.0年，P<0.001)。Logistic回归分析显示,高龄与C-TIRADS4A结节的恶性风险较低相关(OR=0.95,95%CI0.93~0.97,P<0.001)。我们证明了48.5岁或以上患者的恶性肿瘤风险降低。
结论：高龄与C-TIRADS4A结节患者的恶性肿瘤风险降低相关。这项研究表明，除了超声特征外，在评估恶性肿瘤风险时,应考虑患者年龄.
方法：纳入2021年5月至2022年9月在我们机构接受甲状腺FNA的患者。我们收集了人口统计数据,包括年龄,性别,以前的辐射暴露，和家族史。使用当面问卷收集生活方式数据，例如吸烟习惯和饮酒。计算体重指数(BMI)。血清促甲状腺激素(TSH)水平,甲状腺过氧化物酶抗体(TPOAb),测量甲状腺球蛋白抗体（TGAb）。在FNA之前，超声检查报告进行了审查。甲状腺结节FNA的细胞学诊断遵循Bethesda甲状腺细胞病理学报告系统（2017年）。
结果：在252个C-TIRADS4A结节中，103是恶性的。与良性组相比，恶性组患者年龄较小(42.2±13.6vs.51.5±14.0年，P<0.001)。Logistic回归分析显示,高龄与C-TIRADS4A结节的恶性风险较低相关(OR=0.95,95%CI0.93~0.97,P<0.001)。我们证明了48.5岁或以上患者的恶性肿瘤风险降低。
结论：高龄与C-TIRADS4A结节患者的恶性肿瘤风险降低相关。这项研究表明，除了超声特征外，在评估恶性肿瘤风险时,应考虑患者年龄.
