细针抽吸（FNA）活检是一种广泛接受的诊断甲状腺结节的方法。然而，ACR TIRADS 5 (TR5) 甲状腺结节的最大直径 (MD) 对 FNA 结果的影响仍存在争议。本研究探讨了MD对FNA结果的影响，并探讨了TR5结节FNA的最佳MD阈值。我们对我科2022年1月至2022年6月接受FNA的226例患者的280个TR5甲状腺结节进行了回顾性分析。可能恶性（PM）组被定义为细胞病理学中证实有BRAF V600E突变的Bethesda V或Bethesda VI，其他细胞病理学结果被定义为可能良性（PB）组。我们检查了影响恶性细胞病理学结果的因素，并使用逻辑回归和限制三次样条 (RCS) 分析确定了 TR5 结节中 FNA 的最佳 MD 阈值。在这些结节中，58.2% (163/280) 具有 PM 结果。 PM 组的 MD 明显大于 PB 组 [6.5mm（范围 5.0-8.4）vs. 5.3mm（范围 4.0-7.0），p < 0.001]。在完全调整混杂因素的多变量逻辑回归中，MD 与 PM 结果显着相关[比值比 1.16，95% CI 1.05-1.31； p = 0.042]。与最低四分位数相比，MD 最高四分位数出现 PM 结果的可能性更大 [比值比 4.71，95% CI 1.97-11.69，p = 0.001]。 RCS 分析确定 6.2 mm 是 TR5 结节 FNA 的最佳 MD 阈值。MD 显着影响 TR5 甲状腺结节 FNA 恶性结果的概率。建议对这些结节进行 FNA 的 MD 阈值≥6.2mm。版权所有 © 2024 Cao、Shi、Niu、Zhao、Wei、Wu、Peng、Li 和 Yu。

Fine needle aspiration (FNA) biopsy is a widely accepted method for diagnosing thyroid nodules. However, the influence of maximum diameter (MD) of ACR TIRADS 5 (TR5) thyroid nodules on the FNA outcomes remains debated. This study examined the influence of MD on the FNA outcomes and investigated the optimal MD threshold for FNA in TR5 nodules.We conducted a retrospective analysis of 280 TR5 thyroid nodules from 226 patients who underwent FNA from January to June 2022 in our department. Probably malignant (PM) group was defined as Bethesda V in cytopathology with confirmed BRAF V600E mutation or Bethesda VI, the other cytopathology outcomes were defined as probably benign (PB) group. We examined factors influencing malignant cytopathology outcomes and determined the optimal MD threshold for FNA in TR5 nodules using logistic regression and restricted cubic spline (RCS) analysis.Among these nodules, 58.2% (163/280) had PM outcomes. The PM group had a significantly larger MD than the PB group [6.5mm (range 5.0-8.4) vs. 5.3mm (range 4.0-7.0), p < 0.001]. In multivariate logistic regression fully adjusted for confounders, MD was significantly associated with PM outcomes [odds ratio 1.16, 95%CI 1.05-1.31; p = 0.042]. The highest quartile of MD had a greater likelihood of PM outcomes compared to the lowest quartile [odds ratio 4.71, 95% CI 1.97-11.69, p = 0.001]. The RCS analysis identified 6.2 mm as the optimal MD threshold for FNA in TR5 nodules.MD significantly affects the probability of malignant outcomes in FNA of TR5 thyroid nodules. A MD threshold of ≥6.2mm is suggested for FNA in these nodules.Copyright © 2024 Cao, Shi, Niu, Zhao, Wei, Wu, Peng, Li and Yu.