Akromegali Hastalarında Tiroid Nodullerinin TIRADS Skoruyla Değerlendirilmesi ve Kontrol Grubuyla Karşılaştırılması

Year 2021, Volume: 54 Issue: 2, 303 - 306, 31.08.2021

Sevde Nur Fırat Tülay Omma Işılay Taşkaldıran Gönül Koç Cavit Çulha

https://doi.org/10.20492/aeahtd.923923

Abstract

ÖZET
Amaç: Akromegali hastalarında tiroid kanser sıklığının artmış olduğu bilinmektedir. Bu çalışmada akromegali hastalarındaki tiroid nodüllerini Amerikan Radyoloji Koleji (ACR) Tiroid Görüntüleme Raporlama ve Veri Sistemi (TIRADS) skoru ile değerlendirerek, tiroid kanserininin sık görüldüğü bu popülasyonda bu skorun kanseri tespit etmemize faydalı olup olmayacağını tespit etmeyi amaçladık.
Gereç ve Yöntem: Hastanemizde akromegali tanısıyla takip edilen 34 hastanın, endokrinoloji uzmanı tarafından rutin olarak yapılan ve TIRADS skorlaması ile değerlendirilen tiroid ultrasonları ve tiroid ince iğne aspirasyon biyopsi sonuçları restrospektif olarak tarandı. Yaş, cinsiyet ve vücut kitle indeksi olarak benzer olan 37 kontrol hastasının da aynı şekilde endokrinoloji uzmanı tarafından TIRADS skorlaması yapılmış olan ultrason ve tiroid ince iğne aspirasyon biyopsi sonuçları kayıt altına alındı. Her iki grubun TIRADS skorları ve tiroid ince iğne aspirasyon biyopsi sonuçları karşılaştırıldı
Bulgular: Akromegali ve kontrol grupları karşılaştırıldığında TIRADS skorları açısından anlamlı fark çıkmadı. Ancak skoru yüksek olup tiroid ince iğne aspirasyon biyopsi endikasyonu konan nodüllerin malignite oranı akromegali grubunda %33,3 iken, kontrol grubundaki 11 nodulün hepsi benigndi.
Sonuç: Akromegali hastalarındaki tiroid nodülleri, TIRADS skoruyla değerlendirildiğinde, yüksek skora sahip hastalardaki malignite oranının kontrol grubundan fazla olması, bu hastalarda bu skorun maligniteyi öngörmede, basit noduler guatrı olan hastalardan daha iyi olabileceğini göstermektedir.
ABSTRACT
Aim: It is known that the frequency of thyroid cancer is increased in patients with acromegaly. In this study, we aimed to determine whether this score would be useful in detecting cancer in this population where thyroid cancer is common, by evaluating thyroid nodules in patients with acromegaly with the ACR Thyroid Imaging Reporting and Data System (TIRADS) score.
Material and Method: Thyroid ultrasounds and thyroid fine needle aspiration biopsy results, which were routinely performed by an endocrinologist and evaluated by TIRADS scoring, of 34 patients who were followed up with the diagnosis of acromegaly in our hospital, were scanned retrospectively. The ultrasound and thyroid fine needle aspiration biopsy results of 37 control patients who were similar in age, gender and body mass index were also recorded by the endocrinologist for TIRADS scoring. TIRADS scores and thyroid fine needle aspiration biopsy results of both groups were compared.

Results: When acromegaly and control groups were compared, no significant difference was found in terms of TIRADS scores. However, the malignancy rate of nodules with a high score and the indication for thyroid fine needle aspiration biopsy was 33.3% in the acromegaly group, while all 11 nodules in the control group were benign.
Conclusion: When thyroid nodules in acromegaly patients are evaluated with the TIRADS score, the malignancy rate in patients with high scores is higher than the control group, indicating that this score in these patients may be better in predicting malignancy than patients with simple nodular goiter.
Key Words: Acromegaly, TIRADS, thyroid cancer.

Keywords

Akromegali, TIRADS, tiroid kanseri

References

• 1. Melmed S. Medical progress: acromegaly. N Engl J Med. 2006; 355: 2558–73.
• 2. Jenkins PJ, Besser M. Clinical perspective: acromegaly and cancer: a problem. J Clin Endocrinol Metab. 2001; 86: 1509–17.
• 3. Gasperi M, Martino E, Manetti L et al. Prevalence of thyroid diseases in patients with acromegaly: results of an Italian multicenter study. J Endocrinol Invest. 2002; 25: 240–45.
• 4. Popovic V, Damjanovic S, Micic D, et al. Increased incidence of neoplasia in patients with pituitary adenomas. Clin Endocrinol. 1998; 49: 441–45.
• 5. Rogozinski A, Furioso A, Glikman P, et al. (2012) Thyroid nodules in acromegaly. Arq Bras Endocrinol Metabol 56: 300–304.
• 6. Dagdelen S, Cinar, N. & Erbas, T. Increased thyroid cancer risk in acromegaly. Pituitary. 2014; 17, 299–306.
• 7. Brunn J, Block U, Ruf G, et al. Volumetric analysis of thyroid lobes by realtime ultrasound (in German). Dtsch Med Wochenschr .1981;106: 1338–40.
• 8. Shabana W, Peeters E, De Maeseneer M. Measuring Thyroid Gland volume: Should We Change the Correction Factor? AJR Am J Roentgenol. 2006; 186: 234–36.
• 9. Tita P, Ambrosio MR, Scollo C, et al. High prevalence of differentiated thyroid carcinoma in acromegaly. Clin Endocrinol (Oxf). 2005; 63(2):161–67.
• 10. Kurimoto M, Fukuda I, Hizuka N, et al. The prevalence of benign and malignant tumors in patients with acromegaly at a single institute. Endocr J. 2008;55(1):67–71.
• 11. Dos Santos MC, Nascimento GC, Nascimento AG, et al. Thyroid cancer in patients with acromegaly: a case-control study. Pituitary. 2013; 16(1):109–14. Baskin HJ. Ultrasound of Thyroid Nodules. Boston, MA: Kluwer. Academic Publishers; 2000. 12(4):71–86.
• 12. William D. Middleton, Sharlene A, et al. Comparison of Performance Characteristics of American College of Radiology TI-RADS, Korean Society of Thyroid Radiology TIRADS, and American Thyroid Association Guidelines. American Journal of Roentgenology. 2018; 210:5, 1148-54.
• 13. Cibas ES, Ali SZ. The 2017 Bethesda System for Reporting Thyroid Cytopathology. Thyroid. 2017;27(11):1341-46. doi: 10.1089/thy.2017.0500.
• 14. Tan H, Li Z, Li N, et al. Thyroid imaging reporting and data system combined with Bethesda classification in qualitative thyroid nodule diagnosis. Medicine (Baltimore). 2019;98(50): e18320. doi: 10.1097/MD.0000000000018320.