Abstract
Purpose The aim of our study is to investigate whether thyroid nodules (TNs) localization has value as a predictor of malignancy. Ultrasonography provides very valuable information in the evaluation of TNs, but it does not correlate perfectly with histopathologic findings. Therefore, studies that will include new diagnostic methods that can improve these unknowns can be welcomed gratefully. Methods This study was carried out retrospectively in a tertiary care center from September 2016 to January 2020. The study included 862 adult patients who have one or more nodules. Ultrasonography of characteristics of nodules such as echogenicity, content, margins, calcifications, size, and localization was recorded. Fine-needle aspiration biopsy (FNAB) was performed on dominant and suspicious 1142 nodules. Results The patients were composed of 692 (80.3%) females and 170 (19.7%) males. Compared to nodules located in the isthmus; the malignancy risk increased 8.39 (OR: 8.39 (2.34–30.12), p = 0.001) times in the lower pole, 4.27 (OR: 4.27 (1.16–15.72), p = 0.029), times in the middle pole, 8.09 (OR: 8.09 (2.11–30.94), p = 0.002) times in the upper pole, and 7.63 (OR: 7.63 (1.95–29.81), p = 0.003) times in the nodules covering the whole of the lobe. Although the most nodular location was in the middle pole, the risk of malignancy was less than that in the lower and upper poles. Conclusions Unlike the other localization studies, we found a higher risk of malignancy in the lower and similarly upper thyroid poles. Besides well-defined malignancy indicators in the literature and guidelines, localization information is promising for this purpose in the future.
Highlights
IntroductionE aim of our study is to investigate whether thyroid nodules (TNs) localization has value as a predictor of malignancy
Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Sivas Cumhuriyet University, Sivas 58140, Turkey
Introduction yroid nodules (TNs) have been observed as extremely prevalent and are commonly described in patients with no symptoms who are going through assessment for different medical conditions. eir frequency could be affected by many agents, such as iodine sufficiency status and age, and detection rates vary in accordance with the modality of imaging used and the experience of the operator [1, 2]
Summary
E aim of our study is to investigate whether thyroid nodules (TNs) localization has value as a predictor of malignancy. E study included 862 adult patients who have one or more nodules. Unlike the other localization studies, we found a higher risk of malignancy in the lower and upper thyroid poles. 1. Introduction yroid nodules (TNs) have been observed as extremely prevalent and are commonly described in patients with no symptoms who are going through assessment for different medical conditions. In high-resolution ultrasonography (US), the prevalence of TNs lines up from 19% to 68%, with a higher rate in older adults and women. E rising case of thyroid cancer worldwide is linked to the wider use of diagnostic techniques such as ultrasound scans coupled with fine-needle aspiration biopsy (FNAB) of incidentally found small nodules [7, 8]. Overtreatment and overdiagnosis of small papillary thyroid cancers have culminated in a reevaluation of the management approach for the tumors, within a debate on when and how to treat these sort of small, often serendipitously discovered lesions [10, 11]
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