Thyroid Nodules with Indeterminate Cytology and Negative Molecular Profile: Prevalence of Malignancy and Practice Paradigms for Surveillance
Authors' conclusion
Negative subtype of TSv3 should be considered in clinical management recommendations.
Study context
- Population
- Thyroid nodules with The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) III and IV cytology and negative, currently negative, or negative but limited ThyroSeq v3 (TSv3) results, fine needle aspiration (FNA) at one health system, November 2017–March 2022
- Participants
- 556 nodules
- Exposure
- TBSRTC IV vs TBSRTC III molecularly benign nodules
- Outcome
- Prevalence of malignancy (PoM): all nodules (PoM low) and surgically resected nodules (PoM high)
Main finding
As reported in the abstract
PoM in molecularly benign TBSRTC III and IV nodules
Prevalence of malignancy (PoM) range, all vs resected nodules
3% to 23%
Observational data: associations, not effects.
Further findings
TSv3 result distribution
- Negative
- 443 (80%)
- Currently negative
- 85 (15%)
- Negative but limited
- 28 (5%)
Surgical resection
- Resected nodules
- 75
- Immediate surgery
- 54 (9.7%)
- Delayed surgery after surveillance imaging
- 21 (3.8%)
- Immediate resection: currently negative, negative but limited, negative
- 20%, 18%, and 7%; p < 0.001
Ultrasound (US) surveillance of nonoperatively managed nodules (90%)
- ≥1 surveillance US
- 63%
- Timing of initial surveillance US
- 3 to 60 months (median 13 months, IQR 11-19 months)
- Median follow-up
- 25 months (IQR 17-34 months)
- Nodule growth
- 24%
- Repeat FNA
- 7%
Original publication
Thyroid Nodules with Indeterminate Cytology and Negative Molecular Profile: Prevalence of Malignancy and Practice Paradigms for Surveillance. Thyroid. Published 28 January 2025. doi:10.
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