Potential factors for predicting thyroid malignancy in cases of Bethesda system for reporting thyroid cytopathology III and IV nodules

Aim of study was to determine potential factors for predicting malignancy in patients with fine needle aspiration cytology (FNAC) results belonging to Bethesda system for reporting thyroid cytopathology (BSRTC) III and IV categories. One hundred thirteen patients were included in study and divided into two groups regarding the extent of surgery: total thyroidectomy (TT) - 66 and hemithyroidectomy (HT) - 47 patients. A retrospective analysis of demographic parameters, indications for surgery, operation time, excised thyroid gland weight was performed to determine the differences in groups regarding final morphology - benign vs malignant. In TT group 35 (53%) patients had a benign and 31 (47%) a malignant lesion. Analyzed parameters of benign vs malignant groups included: age (55.1±12.6 vs 57.3±13.3, p=0.738), male gender (7 vs 5, p=0.521), compression symptoms (5 vs 1, p=0.110), exclusion of malignancy (28 vs 28, p=0.230), thyrotoxicosis (2 vs 2, p=0.920), operation time (125.9±27.7 vs 140.7±48.2, p=0.241), excised thyroid gland weight (50.4±43.2 vs 28.2±19.7, p = 0.024). In HT group 33 (70%) patients had a benign and 14 (30%) a malignant lesion. Analyzed parameters of benign vs malignant groups included: age (48.1±13.1 vs 51.0±11.3, p=0.269), male gender (11 vs 1, p=0.077), compression symptoms (10 vs 4, p=0.920), exclusion of malignancy (19 vs 10, p=0.368), thyrotoxicosis (4 vs 0, p=0.162), operation time (88.9±21.8 vs 96.7±35.6, p=0.589), excised thyroid lobe weight (28.1±23.4 vs 46.1±98.2[ZN1] , p=0.315). The possibility of malignancy in TT group was higher in patients with a smaller goiter. The excised thyroid gland weight can potentially be used for predicting malignancy in cases of BSRTC III and IV nodules.