- •AUS/FLUS thyroid nodules were subclassified into major or minor concern of cancer.
- •Risk of malignancy in the major vs. minor concern group was 58.4% vs. 12.6% (P-value <0.001).
- •Inter-pathologist agreement for subclassifying AUS/FLUS nodules was 79%, and the κ value = 0.47.
- •Subclassifying AUS/FLUS cases allows for better preop thyroid nodule cancer risk estimation.
The objective of this study was to the assess the risk of malignancy in thyroid lesions that were diagnosed as AUS/FLUS when using a novel cytology subclassification system that is based on the presence or absence of papillary features.
AUS/FLUS case cytology was re-reviewed and subclassified into minor or major concern groups based upon the absence or presence of papillary features, respectively. The risk of malignancy (ROM) was calculated and compared between the two groups. Inter-pathologist agreement in case subclassification was also measured.
The minor concern group had a 12.6% associated ROM, while the major concern group had a significantly higher ROM (58.4%), (P < 0.001). Based on 108 cases, the inter-pathologist agreement in case subclassification was 79%, and the κ value was 0.47.
The identification of papillary features significantly increases the ROM in thyroid lesions with an AUS/FLUS diagnosis.
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Published online: February 26, 2023
Accepted: February 23, 2023
Received in revised form: December 6, 2022
Received: November 9, 2022
Publication stageIn Press Journal Pre-Proof
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