To evaluate surgical outcomes in Bethesda classes I–III nodules and identify risk factors predictive of malignancy, emphasizing the significance of these factors.
Key Findings:
Carcinoma confirmed in 62 out of 192 patients (32.3%), including papillary thyroid carcinoma (PTC) and follicular thyroid carcinoma (FTC).
Malignancy rates: Bethesda class I - 23.5%, class II - 20.4%, class III - 49.4%.
Bethesda class III had a significantly higher incidence of malignancy (p < 0.001).
In class III nodules, larger size and atypia with nuclear and architectural features (AUS-N/A) were associated with malignancy (p = 0.045 and p = 0.028, respectively).
AUS-N/A was an independent predictor of malignancy (odds ratio 13.275, p = 0.026).
Interpretation:
Surgical intervention should be considered for Bethesda class III nodules, especially when AUS-N/A is identified, as it indicates a higher risk of malignancy.
Limitations:
Retrospective nature may introduce selection bias, potentially affecting the generalizability of the results.
Limited to patients who underwent surgery, potentially excluding those managed conservatively.
Conclusion:
Bethesda class III nodules show a higher risk of malignancy, and surgical intervention is warranted in specific cases, particularly when AUS-N/A is present.
