Predictive Value of Ultrasound Risk Classification Combined with Molecular Testing for the Malignant Risk of Cytologically Uncertain Thyroid Nodules
HU Yongbo
MENG Xiang
Abstract：Objective To analyze the predictive value of ultrasound risk classification combined with molecular testing for the malignant risk of cytologically uncertain thyroid nodules.Methods A total of 161 patients with thyroid nodules whose cytological results were uncertain and confirmed by pathology at Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2022 to June 2023 were selected.There were 177 thyroid nodules(Bethesda types Ⅲ,Ⅳ,and Ⅴ)in total,including 118 malignant nodules and 59 benign nodules.The malignant detection rates of cytologically uncertain thyroid nodules in different ultrasound risk classifications,as well as the prediction of the malignant risk of cytologically uncertain thyroid nodules by molecular testing and the pathological results were compared.The predictive value of ultrasound risk classification,molecular testing,and their combination for the malignant risk of cytologically uncertain thyroid nodules was analyzed.Results Comparison of the malignant detection rates of cytologically uncertain thyroid nodules in different ultrasound risk classifications showed statistically significant differences(P＜0.05).The malignant detection rates of cytologically uncertain thyroid nodules with moderate suspicion of malignancy and high suspicion of malignancy were higher than those with extremely low suspicion of malignancy and low suspicion of malignancy(P＜0.05),and the malignant detection rate of cytologically uncertain thyroid nodules with high suspicion of malignancy was higher than those with extremely low suspicion of malignancy,low suspicion of malignancy,and moderate suspicion of malignancy(P＜0.05).Molecular detection results showed 101 true positives,16 false positives,17 false negatives,and 43 true negatives.Receiver operating characteristic curve analysis revealed that the area under the curve for predicting the malignant risk of cytologically uncertain thyroid nodules by ultrasound risk classification,molecular detection,and their combination were 0.828,0.792,and 0.938,respectively.The corresponding sensitivity and specificity were:ultrasound risk classification 76.3％and 81.4％,molecular detection 85.6％and 72.9％,and the combination 83.1％and 88.1％.Conclusion Combined ultrasound risk classification and molecular testing may have a high predictive value for the malignant risk of cytologically uncertain thyroid nodules.
Keywords：ultrasonic risk classificationmolecular testingcytuncertain thyroid nodulesrisk of malignancy
Publication Date：2025-12-28
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：4( 4465-4468 )