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. 2025 Jun;77(3):907-913.
doi: 10.1007/s13304-025-02121-4. Epub 2025 Feb 26.

Analysis of histological features and recurrence risk assessment of papillary thyroid carcinoma according to presurgery FNAC category

Sium Wolde Sellasie  1   2 , Stefano Amendola  3 , Leo Guidobaldi  4 , Tommaso Piticchio  5   6 , Isabella Nardone  3   7 , Simona Zaccaria  3   7 , Giovanni Tacchi  8 , Francesco Pedicini  8 , Luigi Uccioli  3 , Pierpaolo Trimboli  9   10
Affiliations

Analysis of histological features and recurrence risk assessment of papillary thyroid carcinoma according to presurgery FNAC category

Sium Wolde Sellasie et al. Updates Surg. 2025 Jun.

Abstract

Identifying preoperatively cases of more indolent papillary thyroid carcinoma (PTC)could be of high interest. The aim of this study was to verify previously published data on the prognostic value of fine needle aspiration cytology (FNAC)in PTC, also comparing findings from high-volume (HV)and low-volume (LV)institutions. From January 2022 to June 2024, the institutional database of the endocrinological surgery unit of Sant'Eugenio Hospital (Rome, Italy)was retrospectively reviewed to select patients who underwent thyroid surgery for PTC. To evaluate the prognostic value of presurgical FNAC, all histological features and the ATA risk of the study groups were compared. Later, data of patients entirely managed at our institution, considered as an HV institute, were compared with that of cases operated at our institution following FNAC performed LV centres.The 159 PTC nodules included were classified as TIR3B (20.1%),TIR4 (32.7%),and TIR5 (47.2%).The distribution of FNAC report between HV and LV was different (p = 0.01). The presence of lymph node metastasis (p = 0.004), and peri-thyroid tissue invasion (p = 0.02)increased according to the FNAC category. Significant difference among the three FNAC categories was also observed in PTC subtype (p = 0.006)and Hashimoto's thyroiditis (p = 0.02).In addition, a significant different trend was found in ATA risk assessment, being the risk of recurrence more prevalent according to the FNAC category (p = 0.008). According to the second study aim, the higher prevalence of low-risk cases in TIR3B was confirmed in both HV (p = 0.04) and LV (p = 0.03)subgroups.PTCs with preoperative TIR3B have different histological features and ATA risk assessment with respect to cases with presurgical FNAC of TIR4/5.Particularly, PTC from TIR3B should have a pattern of more indolent cancers. As non-negligible extension, this data is not influenced by the institutional setting with high or low thyroid-FNAC volume.

Keywords: ATA risk score; Cytology; Fine needle aspiration; Papillary thyroid carcinoma.

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Conflict of interest statement

Declarations. Conflicts of interest: Authors declare they have no conflict of interest. Research involving human participants and/or animals: All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent: All subjects gave written informed consent for their participation in the study.

Figures

Fig. 1
Fig. 1
ATA risk and FNAC classes distribution according to HV and LV pathological unit
See this image and copyright information in PMC

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