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The 4th edition of the WHO Classification of Tumors of Endocrine Organs, published in 2017, introduced borderline tumours (uncertain malignant potential [UMP] and NIFTP) into thyroid tumour classification [12]. However, these tumours, which are characterised as invasive (papillary thyroid carcinoma [PTC]), incomplete invasive (well-differentiated thyroid tumour [WDT-UMP]) and noninvasive (NIFTP), were still classified as malignant tumours of the intrathyroidal encapsulated follicular variant (EFV) PTC in the 2015 American Thyroid Association (ATA) guidelines. Our laboratory was following the ATA principles during the period of data collection for this study (2012–2017); therefore, among the malignant cases, three patients with WDT-UMP (11.1%) in Bethesda group III and one case (7.7%) in Bethesda group IV were considered at risk of malignancy [13, 14]. There were no cases of NIFTP among our thyroidectomy patients. The rates of malignancy for Bethesda III and IV nodules may vary among institutions, and they are likely to be higher in multicentre studies. In the literature, the malignancy rates for tumours in Bethesda categories are approximated as 10–30% for AUS/FLUS and 25–40% for FN/SFN (including NIFTP in malignant tumours) [4, 8]. In the present study, the malignancy rates for thyroid nodules diagnosed as Bethesda III and IV following resection (25 and 27.6%, respectively) are consistent with the literature. These rates may be considered to guide clinicians when deciding whether to perform a thyroidectomy, as well as to encourage pathologists to reconsider the current recommendations given by the Bethesda System for Reporting Thyroid Cytopathology. However, these results may not be generalisable to AUS/FLUS or FN/SFN cohorts, even though the rates are remarkedly similar to the rates observed in our study. In addition, other published cohorts with a smaller size have reported a malignancy risk for AUS/FLUS nodules as high as 46% [15, 17]. Differences in malignancy rates may be related to variability in randomisation, between institutions or in pathologic interpretation. Cbet online.O Casinor é um modelo HTML de alta qualidade projetado especificamente para sites relacionados a cassinos, jogos de azar e apostas . É uma excelente escolha para quem procura criar uma plataforma.
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