Abstract
BackgroundThis study aimed to evaluate clinical, laboratory, ultrasound (US) and scintigraphyc parameters in thyroid nodule and to develop an auxiliary model for clinical application in the diagnosis of malignancy.MethodsWe assessed 143 patients who were surgically treated at a single center, 65% (93) benign vs. 35% (50) malignant lesions at final histology (1998-2008). The clinical, laboratory, scintigraphyc and US features were compared and a prediction model was designed after the multivariate analysis.ResultsThere were no differences in gender, serum TSH and FT4 levels, thyroid auto-antibodies (TAb), thyroid dysfunction and scintigraphyc results (P = 0.33) between benign and malignant nodule groups. The sonographic study showed differences when the presence of suspected characteristics was found in the nodules of the malignant lesions group, such as: microcalcifications, central flow, border irregularity and hypoechogenicity. After the multivariate analysis the model obtained showed age (>39 years), border irregularity, microcalcifications and nodule size over 2 cm as predictive factors of malignancy, featuring 81.7% of accuracy.ConclusionsThis study confirmed a significant increase of risk for malignancy in patients of over 39 years and with suspicious features at US.
Highlights
Thyroid nodule is a common clinical problem
All patients preoperatively diagnosed with a thyroid nodule by US or clinical examination underwent ultrasound-guided fineneedle aspiration cytology (US-FNAC), and were assessed retrospectively for clinical, laboratory, US and scintigraphyc variables
Malignancy in thyroid nodules was associated to age and suspicious sonographic features
Summary
Thyroid nodule is a common clinical problem. Epidemiologic studies have shown that the prevalence of palpable thyroid nodules are found in approximately 5% of women and in 1% of men living in iodine-sufficient parts of the world [1,2]. Ultrasound (US) studies could detect thyroid nodules in 19-67% of selected individuals with higher frequencies mainly in women and elderly people [3]. The majority of patients with thyroid nodule can be managed conservatively and it justifies the effort to select better candidates for thyroidectomy [4,5,6]. This study aimed to evaluate clinical, laboratory, ultrasound (US) and scintigraphyc parameters in thyroid nodule and to develop an auxiliary model for clinical application in the diagnosis of malignancy
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