{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T17:03:14Z","timestamp":1787936594677,"version":"build-2784847793"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T00:00:00Z","timestamp":1638230400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Activating point mutations of the\n                      <jats:italic>RAS<\/jats:italic>\n                      gene (\n                      <jats:italic>NRAS<\/jats:italic>\n                      ,\n                      <jats:italic>HRAS<\/jats:italic>\n                      , and\n                      <jats:italic>KRAS<\/jats:italic>\n                      ) can be seen in benign and malignant thyroid tumors; among these,\n                      <jats:italic>NRAS<\/jats:italic>\n                      mutations are more commonly seen. This study was conducted to evaluate the thyroid risk of malignancy (ROM) associated with\n                      <jats:italic>RAS<\/jats:italic>\n                      mutations in thyroid fine\u2010needle aspiration (FNA) at the authors' institution.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The authors searched their electronic database system between January 2015 and May 2021 for thyroid FNA cases with any type of\n                      <jats:italic>RAS<\/jats:italic>\n                      mutation. Molecular alterations were identified with the ThyroSeq Genomic Classifier, ThyGeNEXT (thyroid oncogene panel)\/ThyraMIR (miRNA classifier), or ThyroSure gene panel.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 127 cases (age, 51 \u00b1 14 years; 100 females and 27 males) were identified, and 72 had histologic follow\u2010up. The overall ROM associated with\n                      <jats:italic>RAS<\/jats:italic>\n                      mutations (with or without any other molecular alterations) was 29%, whereas the ROM was lower (18%) with\n                      <jats:italic>RAS<\/jats:italic>\n                      mutations only. Isolated\n                      <jats:italic>NRAS<\/jats:italic>\n                      ,\n                      <jats:italic>HRAS<\/jats:italic>\n                      , and\n                      <jats:italic>KRAS<\/jats:italic>\n                      mutation\u2013associated ROMs were 15%, 27%, and 14%, respectively. Among these\n                      <jats:italic>RAS<\/jats:italic>\n                      \u2010mutated cases, the cases with a Bethesda category IV cytologic diagnosis had a higher ROM than the cases with a category III diagnosis (38% vs 17%). Twenty\u2010one histologically confirmed malignant cases were mostly classified on cytology as category IV lesions (14 of 34; 41%), and the remainder were either category III (6 of 35; 17%) or V lesions (1 of 1; 100%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This study demonstrated that the overall\n                      <jats:italic>RAS<\/jats:italic>\n                      mutation\u2013associated ROM in thyroid FNA was intermediate (29%), and isolated\n                      <jats:italic>HRAS<\/jats:italic>\n                      mutations appeared to have a higher ROM (27%) than\n                      <jats:italic>NRAS<\/jats:italic>\n                      and\n                      <jats:italic>KRAS<\/jats:italic>\n                      mutations (15% and 14%, respectively).\n                    <\/jats:p>\n            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Medicine New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Garritano","sequence":"additional","affiliation":[{"name":"Medical Scientist Training Program Yale School of Medicine New Haven Connecticut"},{"name":"Applied Mathematics Program Yale University New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8725-5940","authenticated-orcid":false,"given":"Guoping","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Pathology Yale School of Medicine New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manju L.","family":"Prasad","sequence":"additional","affiliation":[{"name":"Department of Pathology Yale School of Medicine New Haven Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9820-632X","authenticated-orcid":false,"given":"Adebowale 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