Co-detection of BRAF, RAS, RET, TERT promoter, and TP53 in preoperative fine-needle aspiration cytology specimens aids in assessing and predicting the biological behavior of thyroid cancer, effectively guiding tumor recurrence risk stratification, screening for multiple endocrine neoplasia (MEN)-related thyroid carcinomas, and providing a basis for systemic targeted therapy decisions. Here, TERT is linked to multiple endocrine neoplasia.