在没有常规分子测试的情况下,在甲状腺细针吸收中未确定重要性的亚型症的双层分类的表现
Pocholo D Santos1,2, Chiung-Ru Lai2, Jen-Fan Hang2,3,4
1Department of Pathology and Laboratories, Makati Medical Center, Makati, Philippines.
Diagnostic cytopathology
|October 23, 2025
概括
不确定重要性 (AUS) 的亚型分为AUS-核和AUS-其他,显著改善了甲状腺结节的风险分层. 核性AUS病例显示恶性瘤的风险明显更高,与分子检测结果相比.
科学领域:
- 细胞病理学 细胞病理学
- 甲状腺癌的诊断 甲状腺癌的诊断
- 手术病理学手术病理学
背景情况:
- 贝塞斯达甲状腺细胞病理报告系统 (TBSRTC) 引入了一个简化的两层次亚分类,用于未确定重要性 (AUS) 的非典型性.
- 这种分类将AUS病例划分为具有核异型 (AUS-Nuclear) 和其他异型 (AUS-Other) 的AUS.
- 这项研究评估了这些子类别在估计恶性瘤风险时的有用性,而不需要进行常规分子测试.
研究的目的:
- 评估AUS-Nuclear和AUS-Other分类在预测恶性瘤 (ROM) 和瘤 (RON) 风险方面的表现.
- 为了确定这种简化分类在甲状腺细针吸收 (FNA) 诊断中的临床实用性.
- 为了比较AUS子类别的ROM与已建立的分子测试性能.
主要方法:
- 关于在2018年至2023年期间被诊断为AUS的甲状腺FNA病例的回顾性审查.
- 使用手术病理学报告对匹配的FNA向结节进行细胞组织学相关性.
- 计算所有AUS病例的ROM和RON,并按子类别分层.
主要成果:
- 在16030例甲状腺FNA病例中,617例 (3.8%) 被归类为AUS,其中190例进行了组织学随访.
- 与AUS-Other (14.7%) 相比,AUS-Nuclear的恶性瘤 (ROM) 风险明显更高 (54.7%), (p < 0.001).
- 瘤 (RON) 的风险在AUS-Nuclear (67.4%) 与AUS-Other (47.4%) (p = 0.005) 之间也显着更高.
结论:
- 而AUS-Nuclear的ROM显著高于AUS-Other的ROM.
- 对于AUS-Nuclear的ROM可以与像Afirma GSC和ThyroSeq v3.3这样的分子分析的积极预测值进行比较.
- 两层AUS分类增强了风险分层,在没有常规分子测试的情况下证明有价值.
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