The prevalence of thyroid cancers in surgically treated patients with nodular goiter in Şırnak city

Abstract

Objectives: Iodine deficiency is still considered to be the major etiological factor for endemic goiter. The patho­genesis of the goiter in iodine deficient area caries differ­ent characteristics. The aim of this study investigate the prevalence of thyroid cancers and type of thyroid cancers in surgically treated patients with nodular goiter in Şırnak city where is iodine deficiency region. Materials and methods: Thyroid surgical materials which were sent to our department were screened ret­rospectively from the archives between the years 2009-2010. Thyroid resection was performed on 241 patients with nodular goiter in one year. We evaluated patients who received the diagnosis of thyroid carcinoma with hist­hopatological examination. Results: 222 of our patients (92.1%) female and 19 (7.9%) were male. The youngest patient 16 and the old­est patient was 80 years old and the average age is 40.9 ± 12.8. Histopathological examination of 197 (81.7%) cases of nodular goiter, 31 (12.9%) cases lymphocytic thyroiditis, 13 (5.4%) patients had thyroid tumors. The three tumors on the 2 cases (0.8%) benign, 11 (4.6%) were malignant. As a type of cancer 1 (0.4%) patients, fol­licular carcinoma-oncocytic variant, 10 (4.2%) cases were papillary carcinoma. Conclusions: Iodine deficiency area in the province of Şırnak in patients with nodular goiter who underwent sur­gery for thyroid cancer rate of 4.6%, and most cancers is seen as a type of thyroid papillary carcinoma. Key words: Iodine deficiency, endemic goiter, thyroid cancer

Keywords

• Iodine deficiency, endemic goiter, thyroid cancer

Şırnak ilinde ameliyat edilen nodüler guatr olgularında tiroid kanseri görülme sıklığı

Abstract

Amaç: Endemik guatr etyopatogenezinde iyot eksikliği halen majör sebep olarak bilinmektedir. İyot eksikliği böl­gelerinde guatr patogenezi gerek fonksiyonel gerek orga­nik açıdan değişik özellikler gösterebilir. Bu çalışmamızın amacı iyot eksikliği bölgesi olan Şırnak ilinde ameliyat edilen nodüler guatr olgularında tiroid kanseri görülme oranını ve tiroid kanser tiplerini araştırmaktır. Gereç ve yöntem: 2009-2010 yılları arasında yapılan ve bölümümüze gönderilen tiroid ameliyat materyalleri retrospektif olarak arşivden tarandı. Bir yıl içerisinde 241 nodüler guatrlı olguya tiroid cerrahisi uygulanmıştı. Posto­peratif histopatolojik bulgular değerlendirildi. Bulgular: Olgularımızın 222\'si (%92,1) kadın, 19\'u (%7,9) erkektir. En genç hasta 16, en yaşlı hasta 80 ya­şında olup, ortalama yaş 40.9±12,8\'dir. Histopatolojik in­celemede 197 (%81,7) olguda nodüler guatr, 31 (%12,9) olguda lenfositik tiroidit, 13 (%5,4) olguda tiroid tümörü saptandı. On üç tümör olgusunun ise 2\'si (%0,8) benign, 11\'i (%4,6) malign idi. Kanser tipi olarak 1 (%0,4) olguda folliküler karsinom-onkositik varyant, 10 (%4,2) olguda papiller karsinom tespit edildi. Sonuç: İyot eksikliği bölgesi olan Şırnak ilinde ameli­yat edilen nodüler guatr olgularında tiroid kanseri oranı %4,6\'dır ve en fazla kanser tipi olarak tiroid papiller karsi­nomu görülmektedir.

Keywords

• İyot eksikliği, endemik guatr, tiroid kanseri

References

1. Erdoğan MF, Kamel N. Türkiye’nin Değişik Coğrafi Bölge- lerinden Gelen Hastalarda Ötiroid Guatr Etiyolojisinde İyot Eksikliğinin Önemi. Turkiye Klinikleri J Med Sci 1996; 16:364-69.
2. Gürleyik E, Pehlivan M, Özaydın İ, Gökpınar İ, Kıvrak M. İyot Eksikliğine Bağlı Endemik Guatr Bölgesinde Ameliyat Edilen Nodüler Guatr Olgularında Düşük Tiroid Kanseri İn- sidansı. Türkiye Klinikleri J Surg Med Sci 2003; 8:167-71.
3. Kutlu AO, Kara C, Teziç T. Ağır İyot Eksikliğine Bağlı Ge- lişen Jod-Basedow Olgusu. Türkiye Klinikleri J Pediatr 2010;19(1):84-7.
4. Cheung PSY. Medical and surgical treatment of endemic goiter. In: Clark OH, Duh QY, eds. Textbook of Endocrine Surgery. Philadelphia: WB Saunders Co, 1997: 15-21.
5. Slowinska-Klencka D, Klencki M, Sporny S, Lewinski A. Fine-needle aspiration biopsy of the thyroid in an area of endemic goiter: influence of restored sufficient iodine sup- plementation on the clinical significance of cytological re- sults. Eur J Endocrinol 2002; 146:19-26.
6. Benker G, Reiners C. Schilddrüsenkarzinome. In: Seeber S, Schütte J, eds. Therapiekonzepte Onkologie. Berlin- Heidelberg: Springer Verlag, 1995:404-19.
7. Mann K. Schilddrüsenkarzinome. In: Wilmanns W, Huhn D, Wilms K, eds. Internistische Onkologie. Stuttgart-New York: Thieme Verlag, 1994:600-11.
8. Robbins J, Merino MJ, Boice JD, et al. Thyroid cancer: a lethal endocrine neoplasm. Ann Intern Med 1991; 115:133- 47.

9. Kaplan MM. Progress in thyroid cancer. Endocrin Metab Clin N Am 1990; 19(3):469-78.
10. Pfannenstiel P. Erkrankungen der Schilddrüse. In: Wolff HP, Weihrauch TR, eds. Internistische Therapie. München- Wien- Baltimore: Urban.Schwarzenberg 1995:820-40.
11. Delange F. Requirements of Iodine in Humans. In: Delange F, Dun JT, Glinoer D, eds. Iodine Deficiency in Europe. A continuing Concern. Plenum Press, New York, 1993; 5-16.
12. Koutras DA, Matovinovic J, Vought R. The Ecology of Io- dine. In: Stanbury JB, Hetzel BS, 8eds) Endemic Goiter, Endemic Createnism. John Villey, New York, 1980; 185- 95.
13. Erdoğan MF, Erdoğan G. Türkiye ve Dünyada Endemik Guatr ve İyot Eksikliği Rahatsızlıkları. Turkiye Klinikleri J Med Sci 1999;19:106-13.
14. Knudsen N, Perrild H, Christiansen E, Rasmussen S, Dige- Petersen H, Jorgensen T. Thyroid structure and size and two-year follow-up of solitary cold thyroid nodules in an unselected population with borderline iodine deficiency. Eur J Endocrinol 2000;142:224-30.
15. Dumont JE, Lamy F, Roger P, Maenhaut C. Physiological and pathological regulation of thyroid cell proliferation and differentiation by thyrotropin and other factors. Physiol Rev 1992;72:667-97.
16. Peter HJ, Studer H, Groscurth P. Autonomous growth, but not autonomous function, in embryonic human thyroids: a clue to understanding autonomous goiter growth? J Clin Endocrinol Metab 1988;66:968-73.
17. Feldt-Rasmussen U. Iodine and cancer. Thyroid 2001;11:483-6.
18. Lawal O, Agbakwuru A, Olayinka OS, Adelusola K. Thy- roid malignancy in endemic nodular goiters: prevalence, pattern and treatment. Eur J Surg Oncol 2001; 27:157-61.
19. Bakiri F, Djemli FK, Mokrane LA, Djidel FK. The relative roles of endemic goiter and socioeconomic development status in the prognosis of thyroid carcinoma. Cancer 1998; 15:1146-53.
20. Mishra A, Mishra SK, Agarwal A, Das BK, Agarwal G, Gambhir S. Metastatic differentiated thyroid carcinoma: Clinicopathological profile and outcome in an iodine defi- cient area. World J Surg 2002; 26:153-7.
21. Lind P, Kumnig G, Heinisch M, et al. Iodine supplemen- tation in Austria: methods and results. Thyroid 2002; 12:903-7.
22. Burgess JR. Temporal trends for thyroid carcinoma in Aus- tralia: an increasing incidence of papillary thyroid carci- noma (1982-1997). Thyroid 2002; 12:141-9.