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Operation rate and cancer prevalence among thyroid nodules with FNAC report of suspicious for malignancy (TIR4) or malignant (TIR5) according to Italian classification system
a systematic review and meta-analysis

Additional information

Authors
Trimboli P., Ferrarazzo G., Piccardo A., Lucchini B., Durante C.
Type
Journal Article
Year
2022
Language
English
Abstract
Background: In the Italian system for reporting thyroid cytology (ICCRTC), nodules suspicious for (TIR4) and consistent with (TIR5) malignancy are thought being 5% and 4–8% of all biopsies and having risk of malignancy of 60–80% and >95%, respectively. However, no evidence-based data exist about these figures. The present systematic review aimed at achieving solid estimates about TIR4 and TIR5 also considering potential influencing factors. Methods: The review was conducted according to MOOSE. Databases of Google Scholar and Cochrane were searched. No language restriction was used. The last search was performed on February 26th 2022. Quality assessment was performed. Proportion meta-analyses were performed using random-effect model. Statistical analyses were performed using OpenMeta [Analyst]. Results: The online search retrieved 271 articles and 16 were finally included for quantitative analysis. The risk of bias was generally low. The pooled cancer prevalence in TIR4 was 92.5% (95%CI 89.4–95.6%) with unexplained moderate heterogeneity. The pooled cancer rate among TIR5 was 99.7% (95%CI 99.3–100%) without heterogeneity. The resection rate in TIR4 and TIR5 showed heterogeneity, being the latter explained when using their prevalence among biopsies: the higher the prevalence, the higher the operation rate. The pooled risk difference between TIR5 and TIR4 was significant (OR 11.153).
Keywords
Thyroid, Fine-needle aspiration (FNA), Nodules , Carcinoma , Risk of malignancy
Journal
Endocrine
Volume
78
Pages (or article number)
24–31

Diffusion

License
CC BY
Visibility
Public
Status open access
Hybrid