Evaluation of the etiological factors of thyroid gland neoplasms: our clinical experience

Abstract

Objective: Thyroid cancer (TC), the most common endocrine malignancy worldwide, has a 10-year survival rate of more than 90% and a better prognosis than other malignancies. However, there are still conflicting data on the stimulators of cancer development, and benign thyroid diseases, such as goiter, benign thyroid nodules, Graves’ disease, chronic thyroiditis, breast cancer and various factors including age, gender, consumption of vegetables, fiber food, hypercaloric diet, and tobacco and alcohol use are considered to be responsible. In this study, we aimed to evaluate patients with thyroid neoplasms who underwent surgical treatment in terms of etiological factors discussed in light of the literature. Material and Method: In our study, patients who underwent surgery with the diagnosis of thyroid gland neoplasms between 2010 and 2020 were evaluated. A total of 371 patients were included in the study. Statistical analyses were performed using IBM SPSS Statistics v. 22. Results: Of the 371 cases included in the study, 78.16% were female and 21.83% were male. The histopathological distribution of diagnoses was as follows: 76.28% papillary thyroid carcinoma (PTC), 4.31% follicular thyroid carcinoma (FTC), 14.29% follicular adenoma (FA), 0.54% Hurthle cell carcinoma (HCC), 3.77% Hurthle cell adenoma (HCA), and 8.08% medullary thyroid carcinoma (MTC). A total of 567 etiological factors were detected in 371 cases, and the highest factors ratio (1.94) being detected in the FTC group and the lowest (1.49) in the FA group. The most common of these factors was chronic lymphocytic thyroiditis (CLT) (35.31%). While the most common etiological factor in the PTC diagnosis group was thyroid and other non-breast cancers and the history of radiotherapy resulting from their treatment, it was a family history of thyroid cancer in the HCA group. Other systematic organ diseases, CLT, and breast cancer were the most common factors. The body mass index was the highest in the MTC group and the lowest in the PTC group. Conclusion: Increased human development index, technological developments, greater accessibility of ultrasonography, and better diagnostic sensitivity have led to an increase in the detection of TC. Knowledge of the underlying etiological factors is important for the development of preventive measures and achieving more successful results in terms of diagnosis and treatment.

Keywords

• Thyroid Cancer
• Thyroid Gland Neoplasms
• Etiological Factors.

Tiroid bezi neoplazmalarının etiyolojik faktörlerinin değerlendirilmesi: klinik deneyimimiz

Abstract

Amaç: Dünya genelinde en sık karşılaşılan endokrin malignite olan tiroid kanserinde (TK) 10 yıllık sağ kalım oranı %90’dan fazla olup diğer malignitelere göre daha iyi bir prognoza sahiptir. Literatürde TK gelişiminde yaş, cinsiyet, sebze ve lifli besin tüketimi, hiperkalorik diyet,tütün ve alkol kullanımı gibi faktörlerin yanında, kanser gelişimi öncesi guatr, iyi huylu tiroid nodülleri, Graves hastalığı, kronik tiroidit gibi benign tiroid hastalıkları ve meme kanseri birlikteliği konusunda tartışmalar devam etmektedir.Çalışmamızda kliniğimizde cerrahi tedavi uyguladığımız tiroid neoplazmlarını literatür eşliğinde etiyolojik faktörler açısından değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışmamızda 2010-2020 yılları arasında tiroid bezi neoplazmı tanısıyla cerrahi tedavi uyguladığımız hastalar değerlendirildi. Çalışmaya 371 hasta dahil edildi. İstatistikler IBM SPSS Statistics 22 kullanılarak yapıldı. Bulgular: Çalışmaya dahil edilen 371 olgunun %78,16’sı kadın, %21,83’ü erkek cinsiyette olup, tanıların histopatolojik olarak dağılımı %76,28’i papiller tiroid karsinomu (PTK), %4,31’i foliküler tiroid karsinomu (FTK), %14,29’u foliküler adenom (FA), %0,54’ü Hurthle hücreli karsinom (HHK), %3,77’si Hurthle hücreli adenom (HHA) ve %8,08’i medüller tiroid karsinomu (MTK) şeklindeydi. Toplamda 371 olguda 567 etiyolojik faktör tespit edilmiş olup,olgu başına düşen etiyolojik faktör oranı en yüksek (1,94) FTK, en düşük (1,49)FA tanı grubundaydı. Bu faktörler arasında en sık görüleni %35,31 ile kronik lenfositik tiroidit (KLT) idi. PTK tanı grubunda en sık görülen etiyolojik faktör tiroid ve meme dışı diğer kanserler ve bunların tedavisinden kaynaklanan radyoterapi öyküsü iken; HHA’da ailede tiroid kanseri öyküsü olmasıydı. Sistematik diğer organ hastalıkları, KLT ve meme kanseri en sık görülen faktörlerdi. Vücut kitle indeksi (VKİ) değeri ise en yüksek MTK, en düşük PTK tanı grubunda gözlendi. Sonuç: İnsani gelişmişlik indeksinin yükselmesi, teknolojik gelişmeler, ultrasonografinin erişilebilirliği ve tanı duyarlılığındaki yükselme, TK insidansında artışa neden olmaktadır. Bu artışın zemininde yer alan etiyolojik faktörlerin iyi bilinmesi; koruyucu önlemlerin geliştirilmesi, tanı ve tedavi açısından daha başarılı sonuçlar alınması için önemlidir.

Keywords

• Tiroid Kanseri
• Tiroid Bezi Neoplazmaları
• Etiyolojik Faktörler

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