Observational studyJournal of endocrinological investigation2020
Predictors of malignancy in high-risk indeterminate (TIR3B) cytopathology thyroid nodules.
Observational study in Journal of endocrinological investigation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04904159 (A New Scoring System in the Diagnosis of Thyroid Gland Pathologies), which is not on this map. Cited by 11 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A New Scoring System in the Diagnosis of Thyroid Gland Pathologies
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Sociodemographic and clinical predictors of malignancy in thyroid nodules: a systematic review and meta-analysis.Frontiers in endocrinology · 2026Pooled it
- Comprehensive evaluation of TIR 3B thyroid nodules: Clinical, Ultrasonographical and Cytological features for prediction of malignancy.Endocrine · 2026Article
- Patient-specific factors, patient preference, and nodule size as implications in the initial surgery of high risk indeterminate thyroid nodules.Endocrine · 2025Article
- Improving the TIR3B oncological stratification: try to bridge the gap through a comprehensive presurgical algorithm.Journal of endocrinological investigation · 2024Article
- Ultrasound Parameters Can Accurately Predict the Risk of Malignancy in Patients with "Indeterminate TIR3b" Cytology Nodules: A Prospective Study.International journal of molecular sciences · 2023Article
- Editorial: Subclassification of AUS/FLUS category for thyroid nodules: trials and evidence-based clinical management.Frontiers in endocrinology · 2023Article
- Diagnostic accuracy of ultrasonographic features in detecting thyroid cancer in the transition age: a meta-analysis.European thyroid journal · 2022Article
- Article
- TIRADS, SRE and SWE in INDETERMINATE thyroid nodule characterization: Which has better diagnostic performance?La Radiologia medica · 2021Article
- Outcome and diagnostic reproducibility of the thyroid cytology "indeterminate categories" SIAPEC/SIE 2014 in a consecutive series of 302 cases.Journal of endocrinological investigation · 2021Article
- Cost-effectiveness of fine-needle aspiration cytology (FNAC) and watchful observation for incidental thyroid nodules.Journal of endocrinological investigation · 2020Article
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe classification of indeterminate cytopathology at thyroid fine-needle-aspiration (FNA) has been updated to reduce the number of unnecessary surgery; the 2014 Italian classification introduced the low-risk (TIR3A) and high-risk (TIR3B) subcategories. Aim of this study was to identify the ultrasonographic (US), clinical and cytological predictors of malignancy among TIR3B nodules from a single institution.
methodsA prospective observational study including 1844 patients who underwent thyroid FNA from June 2014 to January 2019. Ultrasonographic, clinical and cytological features were recorded. All TIR3B diagnoses were referred to surgery. According to final histology, patients were divided into thyroid cancer (TC) or benign nodules. Chi-square test, or Fisher exact test when appropriate, were used to compare groups and logistic regression analyses were used to determine independent predictors of malignancy.
resultsOf 1844 FNAs, 96 (5.2%) were TIR3B. Histology report was available in 65. Among them, 25 (38.5%) were TC. Predictors of TC were nodule size < 20 mm [Odds Ratio (OR) = 5.88, 95% CI 1.91-18.11, p = 0.002], absence or weak intralesional flow [OR = 0.3, 95% CI 0.09-0.77, p = 0.015], microcalcifications [OR = 6.5, 95% CI 1.90-21.93, p = 0.003] at US; nuclear inclusions [OR = 25.3, 95% CI 1.34-476.07, p = 0.031] and chromatin clearing [OR = 3.7, 95% CI 1.27-10.99, p = 0.017] at cytopathology. Patients aged < 55 years had a significantly higher risk of TC [OR = 9.7, 95% CI 2.79-34.07, p < 0.001]. In multivariate analysis, age < 55 and nodule size < 20 mm resulted as independent risk factors.
conclusionsPatients < 55 years receiving a diagnosis TIR3B on nodules < 20 mm, with microcalcifications, showing specific nuclear atypia at cytopathology are more likely to have TC. Combining US, cytological and clinical features could help determining which patients with a TIR3B diagnosis should be referred to surgery.
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