Evidence map›Paper›PMID 40275442›Full record

ArticleCytopathology : official journal of the British Society for Clinical Cytology2026

Malignancy Risk, Molecular Mutations, and Surgical Outcomes of Thyroid Nodules Classified as Atypia of Undetermined Significance in the Bethesda System: A Comprehensive Analysis.

Caroline Bourque, Gianluca Savoia, Maxine Noik, Livia Florianova, Saruchi Bandargal, Sabrina Daniela da Silva, Richard Payne, Marc Philippe Pusztaszeri

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Article in Cytopathology : official journal of the British Society for Clinical Cytology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. On the Prognostic Implications of Nuclear Atypia in Bethesda III Thyroid Nodules.Cytopathology : official journal of the British Society for Clinical Cytology · 2026
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Caroline BourqueFaculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Gianluca SavoiaFaculty of Science, McGill University, Montreal, Quebec, Canada.ORCID 0009-0004-1728-860X
Maxine NoikFaculty of Science, McGill University, Montreal, Quebec, Canada.
Livia FlorianovaDepartment of Pathology, McGill University, Montreal, Quebec, Canada.
Saruchi BandargalFaculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Sabrina Daniela da SilvaDepartment of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.
Richard PayneDepartment of Otolaryngology-Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.
Marc Philippe PusztaszeriDepartment of Pathology, McGill University, Montreal, Quebec, Canada.ORCID 0000-0001-6490-4189

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThyroid nodules classified as atypia of undetermined significance (AUS) within the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) present a diagnostic challenge, with a risk of malignancy (ROM) of 5% to 50%. In 2017, TBSRTC introduced AUS subcategories to enhance ROM assessment. This study explores the correlation between AUS subclassification, molecular mutations, and surgical outcomes.

methodsRetrospective analysis was performed of 114 AUS cases with molecular profiling by ThyroSeqV3 and surgical follow-up. AUS subcategories as defined by TBSRTC included: AUS-Architectural, AUS-Nuclear, AUS-Nuclear and Architectural, and AUS-Hürthle cell. Pathology diagnoses were categorised as benign, malignant, or borderline, including noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP).

resultsOf the 114 nodules, 32.5% were AUS-Architectural, 28.9% AUS-Nuclear and Architectural, 18.4% AUS-Nuclear, 19.3% AUS-Hürthle cell, and 0.9% AUS-Not Otherwise Specified. Papillary carcinoma, predominantly follicular variant, was the most common diagnosis (47.4%), followed by benign lesions (34.2%) and NIFTP (9.6%). RAS family mutations were the most prevalent molecular alteration (34.2%) followed by DICER1, EIF1AX, EXH1 mutations, CNA and GEP (29.8%). THADA fusions, PTEN, TSHR and BRAFK601E mutations were identified in 10.5% of cases, while high-risk mutations such as BRAF V600E, TERT, and TP53 were found in 8.8% of cases. AUS subcategories demonstrated distinct molecular profiles and were linked to varying surgical outcomes.

conclusionsAUS subcategorization is associated with specific molecular profiles and surgical outcomes, supporting the subclassification of AUS cases per TBSRTC guidelines for improved risk stratification and clinical management. Further prospective studies with larger cohorts are necessary for validation.

Indexed as

Thyroid NeoplasmsThyroid NoduleAdenocarcinoma, FollicularAdultAgedBiopsy, Fine-NeedleCytodiagnosisFemaleHumansMaleMiddle AgedMutationRetrospective StudiesThyroid Glandatypia of undetermined significance (AUS)fine needle aspirationmolecular testingthyroid

Identifiers

PMID40275442
PMCPMC12687694

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.