Trial reportJournal of endocrinological investigation2018
Evaluation of the Italian cytological subclassification of thyroid indeterminate nodules into TIR-3A and TIR-3B: a retrospective study of 290 cases with histological correlation from a single institution.
Trial report in Journal of endocrinological investigation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Thyroid Nodules with Indeterminate FNAC According to the Italian Classification System: Prevalence, Rate of Operation, and Impact on Risk of Malignancy. An Updated Systematic Review and Meta-analysis.Endocrine pathology · 2022Pooled it
- Pooled it
- Comprehensive evaluation of TIR 3B thyroid nodules: Clinical, Ultrasonographical and Cytological features for prediction of malignancy.Endocrine · 2026Article
- Thyroid Nodule Characterization: Overview and State of the Art of Diagnosis with Recent Developments, from Imaging to Molecular Diagnosis and Artificial Intelligence.Biomedicines · 2024Review
- Article
- Exploring the Inter-observer Agreement Among the Members of the Italian Consensus for the Classification and Reporting of Thyroid Cytology.Endocrine pathology · 2020Article
- Predictors of malignancy in high-risk indeterminate (TIR3B) cytopathology thyroid nodules.Journal of endocrinological investigation · 2020Observational
- Impact of the Italian Society of Anatomic Pathology and Diagnostic Cytology Classification of Thyroid Nodules in the Treatment of Indeterminate Follicular Lesions: Five-Year Results at a Single Center.International journal of endocrinology · 2020Article
- Thyroid nodules with Hürthle cells: the malignancy risk in relation to the FNA outcome category.Journal of endocrinological investigation · 2019Article
- A lute player peasant with nodular goiter by Bartolomeo Passarotti (1529-1592).Journal of endocrinological investigation · 2019Article
- Clinical impact of the new SIAPEC-IAP classification on the indeterminate category of thyroid nodules.Journal of endocrinological investigation · 2019Article
- A Monocentric Retrospective Study about the Correlation between Histology and Cytology of Thyroid Indeterminate Nodules Classified as TIR 3A and TIR 3B, according to 2014 Italian Consensus for Classification and Reporting of Thyroid Cytology.Advances in medicine · 2019Article
- Cancer Rate of the Indeterminate Lesions at Low or High Risk According to Italian System for Reporting of Thyroid FNA.Frontiers in endocrinology · 2018Article
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe Italian consensus to classify thyroid cytology has provided a standardized reporting scheme, including the subdivision of indeterminate for malignancy TIR-3 category into TIR-3A (low-risk) and TIR-3B (high-risk). We aimed to present our experience on this subclassification by evaluating risks of malignancy and the validity in sorting nodules with dissimilar risks. Another aim was to compare our performance against the Bethesda system.
methodsFine-needle aspirates of 290 TIR-3 that underwent thyroid surgery at our hospital (2008-2013) were reviewed and divided into TIR-3A or TIR-3B, and AUS/FLUS or FN/SFN. Cytological diagnoses were then correlated to histology. Results were evaluated using univariate analysis.
resultsThe subclassification into TIR-3A and TIR-3B differentiated hyperplastic nodules (p = 0.000) but not adenomas (p = 0.090). Rates of malignancy were significantly different between TIR-3A (10.2%) and TIR-3B (43.8%); TIR-3B malignancies were often papillary carcinomas (83%). TIR-3A/TIR-3B accounted for high sensitivity (84.5%; CI 79.7-88.4%), accuracy (64.1%; CI 58.6-69.6%) and NPV (89.8%; CI 85.6-93.0%) as opposed to modest specificity (55.8%; CI 49.9-61.6%) and PPV (43.8%; CI 38.1-49.8%). The rate of malignancy in AUS-FLUS was higher than in TIR-3A (p = 0.007), whereas it was not different between FN/SFN and TIR-3B (p = 0.337). Sensitivity of the Bethesda system was significantly lower respect to the Italian system.
conclusionsThe study supports the Italian consensus showing a different risk of malignancy for TIR-3A as compared to TIR-3B. TIR-3A/TIR-3B subclassification is valid to sort out benign nodules (high NPV) and malignancies (high sensitivity) but not adenomas (modest specificity, low PPV). In our experience, sensitivity is the main difference between Italian and Bethesda systems.
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