不确定性甲状腺结节（ITNs）的特点是预期的恶性肿瘤发生率在5%至30%之间，大多数患者接受诊断手术而不是治疗手术。我们的研究旨在比较不同地区对待ITNs的方法。在这项回顾性、多中心、国际性研究中，根据世界卫生组织的分类，我们确定了东南亚地区（SEAR）、美洲地区（AMR）、东地中海地区（EMR）、欧洲地区（EUR）和西太平洋地区（WPR）。每个地区包括一个高龄化甲状腺中心。我们比较了不同地区的人口统计学、术前和病理学数据。总体而言，本研究纳入了来自五个高龄化甲状腺中心的5737名患者。我们发现，在全球甲状腺疾病活动中，ITNs的比例在EUR地区（37.6%）比其他地区（21.1-23.6%）高。在EMR地区，患者的年龄明显较年轻（43.1岁的平均年龄），而其他地区的年龄范围为48.8-57.4岁。在WPR地区，半叶切除术的比例显著较高，其中83.2%（114/137）的患者接受了这种治疗，而在其他地区，半叶切除术在44.1-58.1%的患者中进行了。在SEAR中心，恶性病理诊断的比例明显较高，超过60%，而其他地区的中心则在26.3%-41.3%之间。淋巴结转移的发生率在WPR（27.8%）、AMR（26.9%）和EMR（20%）中心高于EUR和SEAR中心，在EUR和SEAR中心低于10%。总之，在我们的研究中发现了不同国家在不确定性甲状腺结节的诊断和治疗中所采取的不同方法和结果。总体而言，接受手术的ITNs患者中，将近60%实际上表现出良性疾病，有可能进行了不必要的手术。

Indeterminate thyroid nodules (ITNs) are characterized by an expected malignancy ranging from 5% to 30%, with most patients undergoing a diagnostic, rather than therapeutic, operation. The aim of our study was to compare the approach to ITNs across different regions of the world. In this retrospective, multicentric, international study, according to the WHO classification, we identified the South East Asian Region (SEAR), the Americas Region (AMR), the Eastern Mediterranean Region (EMR), the Europe Region (EUR), and the Western Pacific Region (WPR). One high-volume thyroid centre was included for each region. Demographic, preoperative, and pathologic data were compared among the different regions. Overall, 5737 patients from five high-volume thyroid centres were included in this study. We found that the proportion of ITNs over the global activity for thyroid disease was higher in the EUR (37.6%) than in the other regions (21.1-23.6%). In the EMR, the patients were significantly younger (with a mean of 43.1 years) than in the other regions (range, 48.8-57.4 years). The proportion of lobectomy was significantly higher in the WPR, where 83.2% (114/137) of patients received this treatment, than in the other regions, where lobectomies were performed in 44.1-58.1% of patients. The pathological diagnosis of malignancy was significantly higher in the SEAR centre, being over 60%, than in centres of the other regions, where it ranged from 26.3% to 41.3%. The occurrence of lymph node metastases was higher in the WPR (27.8%), AMR (26.9%), and EMR (20%) centres than in the EUR and SEAR centres, where it was lower than 10%. In summary, we found in our study different approaches and outcomes in the diagnosis and treatment of ITNs among countries. Overall, almost 60% of patients with ITNs who underwent surgery actually presented a benign disease, potentially undergoing an unnecessary operation.