Clinical and pathologic features for predicting malignancy in thyroid follicular neoplasms

Area of Science:

• Endocrinology
• Oncology
• Pathology

Background:

• Follicular neoplasms lack definitive cytologic features to differentiate between benign adenoma and follicular thyroid carcinoma (FTC).
• Accurate preoperative diagnosis is crucial for appropriate patient management.

Purpose of the Study:

• To identify clinical and cytologic/pathologic features that predict malignancy in patients preoperatively diagnosed with follicular neoplasms.

Main Methods:

• Retrospective analysis of 416 patients with follicular neoplasms who underwent thyroidectomy.
• Review of clinicopathological features, including medical charts and pathologic slides.

Main Results:

• Malignancy or noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) was diagnosed in 50.2% of patients.
• Papillary thyroid carcinoma (PTC)-related nuclear changes were significantly more common in malignant/NIFTP cases (16.3% vs. 1.9%).
• Multivariate analysis identified PTC-related nuclear changes, NRAS mutation, and male sex as significant predictors of malignancy.

Conclusions:

• The prevalence of malignancy in preoperative follicular neoplasms was higher than previously reported.
• Cytologic or pathologic PTC-related nuclear changes are valuable predictors of malignancy.
• Further research is needed to validate these findings.