ECEESPE2025 Poster Presentations Thyroid (141 abstracts)
Unraveling clinical clues for deciphering thyroid nodule malignancy
Nicholas Angelopoulos 1 , Ioannis Androulakis 1 , Dimitrios Askitis 1 , Nicolaos Valvis 1 , Rodis Paparodis 1,2 , Valentina Petkova 1 , Anastasios Boniakos 1 , Dimitra Zianni 1 , Andreas Rizoulis 1 , Sarantis Livadas 1 , Dimitra Bantouna 1 & Juan Carlos Jaume 2
1Hellenic Endocrine Network, Athens, Greece; 2Loyola University Medical Center Maywood, IL and Edward Hines, Jr. VA Hospital, Hines, IL, USA, Endocrinology, Chicago, United States
JOINT438
Background: While most nodules are benign and asymptomatic, certain characteristics may indicate malignancy, prompting fine needle aspiration biopsy. Factors like age and gender affect cancer risk, complicating ultrasound-based risk systems. We aimed to determine whether the cytological malignancy rate of thyroid nodules could be adjusted for several clinical parameters.
Methods: Data from patients aged 18 and above with thyroid nodules assessed via Fine Needle Aspiration (FNA) were retrospectively reviewed. Malignancy classification was based on cytopathology and histopathology Results The study examined how various clinical parameters, adjusted for the ACR TI-RADS category, affected thyroid nodule malignancy rates, including age, sex, Body Mass Index (BMI), nodule size, presence of autoimmunity, and thyroxine therapy. Additionally, we analyzed the performance of ACR TI-RADS in predicting malignant cytology across different age subgroups of thyroid nodules.
Results: The study included 1128 thyroid nodules from 1001 adult patients, with a median age of 48 years and predominantly female (76.68%). Univariate analysis revealed age, sex, and nodule size as risk factors for malignant cytology. For each year of age, there was a 2.33% reduction in the OR for malignant cytology (95% CI: 1.1%-3.1%; P = <0.001). Male sex and nodule size were risk factors for malignant cytology with OR of 1.47(95% CI: 1.10 – 1.95; P = 0.009) and 0.94 (0.93 - 0.96; P < 0.00), respectively. The multivariate logistic regression analysis involving 1128 thyroid nodules, adjusted for ACR TI-RADS categories, sex, and nodule size, showed a 2.5% reduction in the OR for malignant cytology for each year of age. cIntragroup analysis was performed in each group of ACR TI-RADS (TR3, TR4, and TR5) nodules (n = 705) where FNA was indicated. In ACR TI-RADS 3 category nodules, only age strongly predicted malignancy. ROC analyses revealed a diameter of >34 mm as the cut-off value with the best sensitivity and specificity (Youden index 0.564, Sensitivity 83.3 %, and Specificity 73.1%). There was a 4.3% decrease in the odds of malignancy for each year of age increase in patients in the ACR TI-RADS 4 category. For every one-year increase in age, there was a 2.1% decrease in the odds of malignancy for patients in the ACR-TIRADS 5 category.
Conclusion: Raising the size threshold for recommending FNA of TR3-3 nodules and incorporating patients’ age and gender into the evaluation process could enhance the system’s accuracy in assessing thyroid nodules and guiding clinical management decisions.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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