Investigating the Applicability of the McGill Thyroid Nodule Score (MTNS) in Patients Undergoing Surgery for Thyroid Nodules: A Comparison Between Patients with and Without Papillary Thyroid Cancer

Objective: Various algorithms are currently used to evaluate patients with thyroid nodules. Thyroid fine needle aspiration biopsy (FNAB) is the most valuable method for assessment, but it yields 5-10% false negative results. Therefore, the McGill Thyroid Nodule Score (MTNS), which consists of 22 parameters, was developed for use in the preoperative period. In this study, we investigated the applicability of MTNS in patients with indeterminate FNAB results by comparing patients diagnosed with papillary thyroid cancer to those with benign outcomes according to the specimen result. Materials and Methods: Between January 2016 and August 2017, 382 patients who underwent thyroidectomy at our clinic were evaluated. A total of 140 patients categorized as Bethesda III- IV-V were included in the study. The MTNS was calculated and compared between the malignant and benign groups. Subsequently, patients were divided into four groups based on nodule diameter to evaluate their MTNS. Results: The median MTNS was 6 (range 1-16) in the benign group and 12 (range 3-23) in the malignant group. To determine the cut-off for MTNS, Receiver Operating Characteristic (ROC) analysis was conducted using the pathology result as the primary endpoint. The cut-off value was determined to be 8.5. Statistical analysis revealed that the sensitivity and specificity of MTNS were 83.0% and 85.5%, respectively. Conclusion: Ultrasonography (USG) and FNAB are currently preferred methods for approaching patients with thyroid nodules. In cases where FNAB results are inconclusive, MTNS can be safely applied clinically to identify high-risk patients.