Petrov Thyroid Cancer Score (PTCS): evaluation of practical significance on the basis of postsurgical morphological analysis

The study objective is to evaluate the results of using the Petrov Thyroid Cancer Score (PTCS) in 2018 and assess the diagnostic value of the original PTCS and modified PTCS.

Materials and methods. PTCS, proposed in the N.N. Petrov National Medical Research Center of Oncology in early 2018, was tested in this institution in 310 patients, 99 of whom underwent surgery, mainly due to suspected malignancy of thyroid nodules or at the request of patients.

Results. According to the standard histological evaluation, in 35 cases the process was considered benign (group Д), while in 61 cases — after exclusion of 3 medullary carcinomas — regarded as highly differentiated (according to previous classification) thyroid cancer (group Р). The average values of such components of PCTS as BethesdaScore, TI-RADSScore, ElastoScore and body mass index (BMI) in group Р were significantly higher than in group Д. The sum of the scores of the used four parameters was not only higher in group Р, but also at a magnitude of ≥5.0 (62.3 % of observations in this group) it always corresponded to the diagnosis of thyroid carcinoma. At the same time, a similar histological conclusion was made, in particular, in respect of 14 patients (23 % of the group Р contingent) with the value of the mentioned sum <3.5. Of note, according to the preoperative cytological study, among these 14 cases 11 follicular neoplasms and 3 colloid nodules were found.

Conclusion. A high value (≥5.0) of the sum of four selected parameters (3 from PTCS + BMI_Score) indicates an extremely high probability of detecting a tumor process, while in other cases (and not only under the assumption of follicular neoplasia presence), an additional diagnostic methods of research are needed.

1. Belyaev A.M., Berstein L.M., Vasil’ev D.A. et al. Diagnostic score of malignancy risk in the people having a node in thyroid gland (Petrov Thyroid Cancer Score, PTCS) Opukholi golovy i shei = Head and Neck Tumors 2018;8(1):17—23. (In Russ.). DOI: 0.17650/2222-1468-2018-8-1-17-23.

2. Jackson B.S. Controversy regarding when clinically suspicious thyroid nodules should be subjected to surgery: review of current guidelines. Medicine (Baltimore) 2018;97(50):e13634. DOI: 10.1097/MD.0000000000013634.

3. Russ G., Leboulleux S., Leenhardt L., HegedUs L. Thyroid incidentalomas: epidemiology, risk stratification with ultrasound and workup. Eur Thyroid J 2014;3(3):154—63. DOI: 10.1159/000365289.

4. Haugen B.R., Alexander E.K., Bible K.C. et al. 2015 American Thyroid Association Management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 2015;26(1):1 —133. DOI: 10.1089/thy.2015.0020.

5. Beltse-vich D.G., Vanushko V.E., Rumyantsev P.O. et al. 2017 Russian clinical practice guidelines for differentiated thyroid cancer diagnosis and treatment. Endokrinnaya Khirurgiya = Endocrine Surgery 2017;11(1):6—27. (In Russ.). DOI: 10.14341/serg201716_27.

6. Schmid D., Ricci C., Behrens G., Leitzmann M.F. Adiposity and risk of thyroid cancer: a systematic review and meta-analysis. Obes Rev 2015;16(12): 1042-54. DOI: 10.1111/obr.12321.

7. Kwon H., Chang Y., Cho A. et al. Metabolic obesity phenotypes and thyroid cancer risk: a cohort study. Thyroid 2019;29(3):349-58. DOI: 10.1089/thy.2018.0327.

8. Samsonov R., Burdakov V., Shtam T. et al. Plasma exosomal miR-21 and miR-181a differentiates follicular from papillary thyroid cancer. Tumour Biol 2016;37(9):12011-21. DOI: 10.1007/s13277-016-5065-3.

9. Steward D.L., Carty S.E., Sippel R.S. et al. Performance of a multigene genomic classifier in thyroid nodules with indeterminate cytology: a prospective blinded multicenter study. JAMA Oncol 2018 Nov 8. DOI: 10.1001/jamaoncol.2018.4616.

10. Nikiforov Y.E., Carty S.E., Chiosea S.I. et al. Impact of the multi-gene ThyroSeq next-generation sequencing assay on cancer diagnosis in thyroid nodules with atypia of undetermined significance/ follicular lesion of undetermined significance cytology. Thyroid 2015;25(11):1217-23. DOI: 10.1089/thy.2015.0305.