{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T15:28:56Z","timestamp":1779377336821,"version":"3.53.1"},"reference-count":43,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The third edition of the Bethesda system for reporting thyroid cytopathology recommends a simplified two\u2010tiered subclassification of atypia of undetermined significance (AUS), dividing cases into AUS with nuclear atypia (AUS\u2010Nuclear) and other atypia (AUS\u2010Other). This study aims to evaluate the performance of these subcategories in estimating the risk of malignancy (ROM) in a setting without routine molecular testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was conducted on consecutive thyroid fine\u2010needle aspiration (FNA) cases diagnosed as AUS between 2018 and 2023. Surgical pathology reports were matched with the FNA\u2010targeted nodules to enable cyto\u2010histologic correlation. ROM and risk of neoplasm (RON) were calculated for all AUS cases and for each subcategory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 16,030 thyroid FNA cases, 617 (3.8%) were diagnosed as AUS. Histologic follow\u2010up was available in 190 cases. Final diagnoses included non\u2010neoplastic lesions (42.6%), benign neoplasms (17.4%), low\u2010risk neoplasms (5.3%), and malignant neoplasms (34.7%). The ROM for AUS\u2010Nuclear was significantly higher at 54.7%, compared to 14.7% for AUS\u2010Other (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Similarly, the RON was significantly higher in the AUS\u2010Nuclear group (67.4%) than in the AUS\u2010Other group (47.4%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AUS\u2010Nuclear carries a substantially higher ROM than AUS\u2010Other, with a ROM (54.7%) comparable to the reported positive predictive values of molecular assays such as Afirma GSC (47%, 95% CI: 36%\u201358%) and ThyroSeq v3 (66%, 95% CI: 56%\u201375%). These findings support the clinical utility of the two\u2010tiered AUS subclassification in enhancing risk stratification, particularly in settings where molecular testing is not routinely available.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dc.70034","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T11:59:57Z","timestamp":1761220797000},"page":"78-86","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Performance of Two\u2010Tiered Subclassification of Atypia of Undetermined Significance in Thyroid Fine\u2010Needle Aspiration Without Routine Molecular Testing"],"prefix":"10.1002","volume":"54","author":[{"given":"Pocholo D.","family":"Santos","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratories Makati Medical Center  Makati Philippines"},{"name":"Department of Pathology and Laboratory Medicine Taipei Veterans General Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiung\u2010Ru","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Taipei Veterans General Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jen\u2010Fan","family":"Hang","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Department of Pathology, School of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Institute of Clinical Medicine, National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"1039","article-title":"The 2023 Bethesda System for Reporting Thyroid Cytopathology","volume":"33","author":"Ali S. 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