Definition of Clinical Risk Factors for Differential Thyroid Cancers in Patients with Nodular Goiter

Abstract

Objective: This study aimed to evaluate the clinical, radiological, and laboratory risk factors for differentiated thyroid cancers in patients with nodular thyroid disease and to investigate the relationship between these findings and the cytopathological features of the nodules. Materials and Methods: Demographic data, laboratory and imaging findings, and fine-needle aspiration pathology results of 323 patients with incidentally detected thyroid nodules during clinical or radiological examination at the Endocrinology Clinic were retrospectively evaluated and recorded. Results: Fine-needle aspiration biopsy of the dominant nodules revealed that 309 (95.6%) patients had benign nodules, while 14 (4.33%) had malignant nodules. Among patients with benign nodules, microcalcifications were detected in 274 (88.7%) cases, and macrocalcifications were observed in 18 (5.8%). In the malignant group, irregular nodule margins were noted in 1 (7.1%) patient, and multinodular goiter was present in 8 (57.1%). On thyroid ultrasound imaging, 8 (57.1%) patients with malignant nodules exhibited hypoechoic nodules, and 4 (28.6%) displayed microcalcifications. The internal structure of malignant dominant nodules was heterogeneous in 10 (71.4%) cases. Conclusion: This study examined the relationship between histological results and various nodule characteristics, including echogenicity, diameter, calcification type, edge irregularity, autoimmunity, thyroid hormone levels, and cystic content. No significant associations were identified in the analyses, including the presence of microcalcifications (p = 0.074). Broad-spectrum prospective studies with larger patient cohorts are needed to provide further insights and contribute to the existing literature.

Keywords

• Nodular goiter
• Thyroid cancer
• Risk factors

Nodüler Guatrli Hastalarda Diferansiye Tiroid Kanserleri için Klinik Risk Faktörlerinin Tanımlanması

Abstract

Amaç: Çalışmamızda, nodüler tiroid hastalarda diferansiye tiroid kanserleri için klinik, radyolojik ve laboratuar risk faktörlerinin değerlendirilmesi ve bu bulguların nodüllerin sitopatolojik özellikleri ile ilişkisinin saptanması amaçlanmıştır. Gereç ve Yöntemler: Endokrinoloji Polikliniğine başvuran, muayene ile veya radyolojik tetkik sırasında tesadüfi olarak tiroid nodülü saptanan 323 hastanın demografik verileri, laboratuvar ve görüntüleme bulguları, ince iğne aspirasyon patoloji sonuçları retrospektif olarak değerlendirildi ve kaydedildi. Bulgular: Olguların dominant nodüllerinden yapılan ince iğne aspirasyon biyopsisi sonucunda 309(%95,6) hastanın benign, 14(%4,33) hastanın ise malign nodüle sahip olduğu saptanmıştır. Benign nodüle sahip olguların 274’ünde(%88,7) mikrokalsifikasyon, 18’inde(%5,8) makrokalsifikasyon saptandı. Malign nodüllü olguların 1 (%7.1) inde nodül sınırları düzensiz, hastaların 8(%57,1) inde multinodüler guatr tespit edildi. Tiroid ultrason görüntülemesinde 82(%57,1) hastanın nodülleri hipoekoik iken 4(%28,6) hastada mikrokalsifikasyon mevcuttu. Malign dominant nodülün iç yapısı 10(%71,4) olguda heterojen izlendi. Sonuç: Histolojik sonuçlarla nodüllerin yapısı, ekojenitesi, çapı, kalsifikasyon içeriği, kenar düzensizliği, eşlik eden otoimmunite, tiroid hormon düzeyi, kistik içeriği arasında ilişki araştırılmış ancak yapılan analizlerde ilişki saptanmamıştır. Mikrokalsifikasyon varlığı açısından tüm gruplarda anlamlı fark izlenmemiştir (p=0.074). Bu konuda literatüre katkı amaçlı daha çok hasta içeren geniş spektrumlu prospektif çalışmaların dizayn edilmesine ihtiyaç vardır.

Keywords

• Noduler guatr
• Tiroid kanser
• Risk faktörleri

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