The effect of serum 25-hydroxy vitamin D levels on malignancy in exophytic thyroid nodules

Year 2022, Volume: 5 Issue: 5, 1299 - 1302, 25.09.2022

İsmail Emre Arslan , Sema Hepşen , Pınar Akhanlı , Bekir Ucan , İlknur Öztürk Ünsal , Murat Çalapkulu , Erman Çakal

https://doi.org/10.32322/jhsm.1128198

Abstract

Aim: The increase in the incidence of thyroid cancer brings about research of new risk factors. In this study, we aimed to investigate the effect of vitamin D status on malignancy in exophytic nodules.
Material and Method: Two hundred and sixteen patients with exophytic thyroid nodules were included in the study. All patients’ thyroid nodule ultrasonographic features, fine needle aspiration biopsy cytology results, rate of surgery and surgery histopathological results were recorded. Vitamin D levels were analyzed and patients were divided into two groups as vitamin D sufficient groups (vitamin D≥20 ng/ml) and vitamin D deficient group (vitamin D<20 ng/ml).
Results: Malignancy rate was significantly higher in the vitamin D deficient group (%19 vs %8.7; p=0.03). There were no significant difference between two groups in terms of demographic characteristics and ultrasonographic features including diameter, hypoechoic nature, having irregular border and microcalcifications.
Conclusion: In exophytic nodules, vitamin D deficiency increases malignancy risk. Determining vitamin D levels may be useful in patients with exophytic nodules.

Keywords

Thyroid nodule, thyroid malignancy, exophytic nodule, vitamin D

References

• Pellegriti G, Frasca F, Regalbuto C, Squatrito S, Vigneri R. Worldwide increasing incidence of thyroid cancer: update on epidemiology and risk factors. J Cancer Epidemiol 2013; 2013: 965212.
• Haugen BR, Alexander EK, Bible KC, et al 2015 American Thyroid Association Management Guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid 2016; 26: 1-133.
• Bogović Crnčić T, Ilić Tomaš M, Girotto N, Grbac Ivanković S. Risk factors for thyroid cancer: what do we know so far?. Acta Clin Croat 2020; 59: 66-72.
• Laney N, Meza J, Lyden E, Erickson J, Treude K, Goldner W. The prevalence of vitamin D deficiency is similar between thyroid nodule and thyroid cancer patients. Int J Endocrinol 2010; 2010: 805716.
• Stepien T, Krupinski R, Sopinski J, et al. Decreased 1-25 dihydroxyvitamin D3 concentration in peripheral blood serum of patients with thyroid cancer. Arch Med Res 2010; 41: 190-4.
• Roskies M, Dolev Y, Caglar D, et al. Vitamin D deficiency as a potentially modifiable risk factor for thyroid cancer. J Otolaryngol Head Neck Surg 2012; 41: 160-3.
• Clinckspoor I, Verlinden L, Mathieu C, Bouillon R, Verstuyf A, Decallonne B. Vitamin D in thyroid tumorigenesis and development. Prog Histochem Cytochem 2013; 48: 65-98.
• Kim JR, Kim BH, Kim SM, et al. Low serum 25 hydroxyvitamin D is associated with poor clinicopathologic characteristics in female patients with papillary thyroid cancer. Thyroid 2014; 24: 1618-24.
• Deeb KK, Trump DL, Johnson CS. Vitamin D signalling pathways in cancer: potential for anticancer therapeutics. Nat Rev Cancer 2007; 7: 684-700.
• Gupta D, Vashi PG, Trukova K, Lis CG, Lammersfeld CA. Prevalence of serum vitamin D deficiency and insufficiency in cancer: Review of the epidemiological literature. Exp Ther Med 2011; 2: 181-93.
• Zhao J, Wang H, Zhang Z, et al. Vitamin D deficiency as a risk factor for thyroid cancer: A meta-analysis of case-control studies. Nutrition 2019; 57: 5-11.
• Alexander EK, Marqusee E, Orcutt J, et al. Thyroid nodule shape and prediction of malignancy. Thyroid 2004; 14: 953-8.
• Chan BK, Desser TS, McDougall IR, Weigel RJ, Jeffrey RB Jr. Common and uncommon sonographic features of papillary thyroid carcinoma. J Ultrasound Med 2003; 22: 1083-90.
• Hoang JK, Lee WK, Lee M, Johnson D, Farrell S. US Features of thyroid malignancy: pearls and pitfalls. Radiographics 2007; 27: 847-65.
• Iannuccilli JD, Cronan JJ, Monchik JM. Risk for malignancy of thyroid nodules as assessed by sonographic criteria: the need for biopsy. J Ultrasound Med 2004; 23: 1455-64.
• Jun P, Chow LC, Jeffrey RB. The sonographic features of papillary thyroid carcinomas: pictorial essay. Ultrasound Q 2005; 21: 39-45.
• Khoo ML, Asa SL, Witterick IJ, Freeman JL. Thyroid calcification and its association with thyroid carcinoma. Head Neck 2002; 24: 651-5.
• Wienke JR, Chong WK, Fielding JR, Zou KH, Mittelstaedt CA. Sonographic features of benign thyroid nodules: interobserver reliability and overlap with malignancy. J Ultrasound Med 2003; 22: 1027-31.
• Papini E, Guglielmi R, Bianchini A, et al. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab 2002; 87: 1941-6.
• Frates MC, Benson CB, Charboneau JW, et al. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Ultrasound Q 2006; 22: 231-40.
• Dellal FD, Baser H, Arpaci D, et al. Rate of malignancy in exophytic thyroid nodules. Iran J Radiol 2017; 14: e41141.
• Koike E, Noguchi S, Yamashita H, et al. Ultrasonographic characteristics of thyroid nodules: prediction of malignancy. Arch Surg 2001; 136: 334-7.
• Russ G, Bonnema SJ, Erdogan MF, Durante C, Ngu R, Leenhardt L. European Thyroid Association Guidelines for ultrasound malignancy risk stratification of thyroid nodules in adults: the EU-TIRADS. Eur Thyroid J 2017; 6: 225-37.
• Kim DW, Jung SJ, Baek HJ. Computed tomography features of benign and malignant solid thyroid nodules. Acta Radiol 2015; 56: 1196-202.
• Muzza M, Degl'Innocenti D, Colombo C, et al. The tight relationship between papillary thyroid cancer, autoimmunity and inflammation: clinical and molecular studies. Clin Endocrinol (Oxf) 2010; 72: 702-8.
• Hansen CM, Binderup L, Hamberg KJ, Carlberg C. Vitamin D and cancer: effects of 1,25(OH)2D3 and its analogs on growth control and tumorigenesis. Front Biosci 2001; 6: 820-48.
• Giovannucci E. Vitamin D status and cancer incidence and mortality. Adv Exp Med Biol 2008; 624: 31-42.
• Guarino V, Castellone MD, Avilla E, Melillo RM. Thyroid cancer and inflammation. Mol Cell Endocrinol 2010; 321: 94-102.
• Sahin M, Uçan B, Giniş Z, et al. Vitamin D3 levels and insulin resistance in papillary thyroid cancer patients. Med Oncol 2013; 30: 589.
• Kim MJ, Kim D, Koo JS, Lee JH, Nam KH. Vitamin D receptor expression and its clinical significance in papillary thyroid cancer. Technol Cancer Res Treat 2022; 21: 15330338221089933.
• Choi YM, Kim WG, Kim TY, et al. Serum vitamin D3 levels are not associated with thyroid cancer prevalence in euthyroid subjects without autoimmune thyroid disease. Korean J Intern Med 2017; 32: 102-8.
• Danilovic DL, Ferraz-de-Souza B, Fabri AW, et al. 25-hydroxyvitamin D and TSH as risk factors or prognostic markers in thyroid carcinoma. PLoS One 2016; 11: e0164550.
• Heidari Z, Nikbakht M, Mashhadi MA, et al. Vitamin D deficiency associated with differentiated thyroid carcinoma: a case- control study. Asian Pac J Cancer Prev 2017; 18: 3419-22.
• Jonklaas J, Danielsen M, Wang H. A pilot study of serum selenium, vitamin D, and thyrotropin concentrations in patients with thyroid cancer. Thyroid 2013; 23: 1079-86.
• Demircioglu ZG, Aygun N, Demircioglu MK, Ozguven BY, Uludag M. Low vitamin D status is not associated with the aggressive pathological features of papillary thyroid cancer. Sisli Etfal Hastan Tip Bul 2022; 56: 132-6.