中国医学科学院学报2025，Vol.47Issue(1)：23-28,6.DOI:10.3881/j.issn.1000-503X.16040
超声低估甲状腺3类和4a类结节的细胞和组织病理表现
Cellular and Histopathological Characteristics of Ultrasonically Underdiagnosed 3/4a Thyroid Nodules
摘要
Abstract
Objective To analyze the cellular and histopathological characteristics of underdiagnosed thyroid nodules of Chinese thyroid imaging reporting and data system(C-TIRADS)categories 3 and 4a,thus improving the understanding of these lesions.Methods The data of ultrasound and fine needle aspiration cytology were collected from 683 nodules diagnosed based on pathological evidence in 549 patients undergoing thyroid surgery.The cellular and histopathological characteristics of C-TIRADS 3 and 4a nodules were ana-lyzed.Results Two hundred and sixty-eight nodules were classified as C-TIRADS category 3,including 236 benign nodules,12 low-risk ones,and 20(7.46%)malignant ones.Two hundred and twenty-one nodules were classi-fied as C-TIRADS category 4a,including 133 benign nodules,7 low-risk ones,and 81(36.65%)malignant ones.The malignancy rates differed between C-TIRADS 3 and 4a nodules(χ2=58.93,P<0.001),and both were higher than the recommended malignancy rate in the guidelines for malignancy risk stratification of thyroid nodules(C-TIRADS)(both P<0.001).According to the pathological evidence,the underdiagnosed C-TI-RADS 3/4a nodules were mainly papillary thyroid carcinoma,especially in patients with Hashimoto thyroidi-tis.There was not a consistent one-to-one match between each ultrasound result and each cytological classification of low-risk thyroid nodules.Conclusions When the malignant features in preoprative ultrasound imaging are atypical or absent,papillary thyroid carcinoma(especially with Hashimoto thyroiditis),follicular carcinoma,and medullary carcinoma are likely to be underdiagnosed as C-TIRADS 3 or 4a nodules.Therefore,efforts should be made to fully understand the cellular and pathological characteristics of these lesions.关键词
甲状腺结节/低估恶性风险/血糖/病理/中国甲状腺影像报告与数据系统Key words
thyroid nodule/underdiagnosed malignancy risk/blood glucose/pathology/Chinese thyroid imaging reporting and data system分类
基础医学引用本文复制引用
吴玮琦,许存宝,李尤佳,苏春阳,张峰顺,陈一峰..超声低估甲状腺3类和4a类结节的细胞和组织病理表现[J].中国医学科学院学报,2025,47(1):23-28,6.基金项目
福建省自然科学基金(2023J011792) （2023J011792）
