Prevalence Of Thyroid Nodules Research Articles

Our 2016 Cancer Cytopathology Young Investigator.

Our 2016 Cancer Cytopathology Young Investigator.

Incidental thyroid nodules on thoracic contrast-enhanced computed tomography in clinical practice during a 10-year period: Characteristics, clinical outcomes, and factors contributing to further evaluation.

The purposes of this study were to assess the prevalence, malignancy rate, and characteristics of incidental thyroid nodules (ITNs), and to identify factors that contribute the additional workup by ultrasound.The medical records and imaging features of ITNs reported via thoracic computed tomography (CT) were retrospectively reviewed to determine the size, multiplicity, attenuation, shape, and presence of calcification. To identify the factors associated with additional workup, we compared the workup and non-workup groups in terms of nodule characteristics, indications, and CT slices. We identified factors that could distinguish malignant ITNs from non-malignant nodules.A total of 60,921 thoracic CT scans met the inclusion criteria, and ITNs were reported using formal radiology in 2733 patients (4.5%). Among all patients with reported ITNs, 546 (20.0%) underwent further workup. Of these patients, 62 (2.3%, 62/2773) were diagnosed with malignant nodules. Multivariable analysis identified multiple factors associated with additional workup, including female sex, younger age, larger nodule size, calcification, anteroposterior to transverse dimension ratio >1, heterogeneous attenuation in the nodule, and scanning indications such as infection or screening. However, only calcification was associated with malignant nodules (odds ratio [OR] = 2.313; 95% confidence interval [CI], 1.301–4.113).We observed discordance between the numbers of reported ITNs and case with additional workup and identified multiple factors associated with additional workup. We have, therefore, demonstrated a need for reliable subsequent evaluation guidelines and note that the appearance of calcification in an ITN on imaging may be a factor indicating the need for additional workup.

Metformin and thyroid disease.

An intriguing area of research in thyroidology is the recently discovered association of insulin resistance with thyroid functional and morphological abnormalities. Individuals with hyperinsulinemia have larger thyroid gland and a higher prevalence of thyroid nodules and cancer. Accordingly, patients treated with metformin have a smaller thyroid volume and a lower risk of incident goiter, thyroid nodule and cancer. Multiple studies in vitro and in vivo have demonstrated that metformin can inhibit the growth of thyroid cells and different types of thyroid cancer cells by affecting the insulin/IGF1 and mTOR pathways. Besides, metformin treatment was associated with a decrease in the levels of serum thyroid-stimulating hormone (TSH) in diabetic patients possibly by enhancing the effects of thyroid hormones in the pituitary and activating the adenosine monophosphate-activated protein kinase (AMPK). Based on this evidence, metformin appears to be a promising therapeutic tool in patients with thyroid disease. More clinical studies are necessary to evaluate the clinical significance of metformin for the treatment of thyroid diseases.

The prevalence of thyroid nodules in northwest China and its correlation with metabolic parameters and uric acid.

This study aimed to estimate the prevalence of thyroid nodules (TN) and investigate its correlation with metabolic parameters, especially uric acid (UA) in northwest Chinese population. We conducted a large cross-sectional survey with 67,781 residents (33,020 men, 34,761 women), aged from 18 to 86 years in Shanxi, China, from January 2012 to December 2014. A thyroid ultrasound examination was performed with number and size of nodules being recorded. Metabolic parameters including body mass index (BMI), blood pressure (BP), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), fasting glucose (FG), and uric acid (UA) were also examined. Our study revealed that approximately 30.7% of men and 39.9% of women in Northwest China had TN, about half of which were multi-nodularity and a quarter of their TN larger than 1 cm. The prevalence of TN increased with aging and increasing BMI, and metabolic disorders, which also related to the increased incident of multi-nodularity and larger TN. Serum UA appeared to be a protective factor for TN in men older than 30 years, but a risk factor in both men younger than 30 years and women older than 30 years. This phenomenon needs to be further investigated.

Factors Associated with the Prevalence of Thyroid Nodules and Goiter in Middle-Aged Euthyroid Subjects.

The aim of the present study was to determine associations of thyroid hormone levels and different metabolic parameters and anthropometric measurements with volume of nodular and nonnodular thyroid as well as with prevalence of goiter and thyroid nodules in middle-aged euthyroid subjects. Methods. The study consisted of 317 euthyroid subjects aged 48-49 from the Kaunas Cardiovascular Risk Cohort study. Thyroid-stimulating hormone (TSH), free thyroxine (FT4), and antithyroid peroxidase antibody (ATPO) levels, as well as anthropometric and metabolic parameters and smoking information, were evaluated. Results. In subjects with and without thyroid nodules, thyroid volume correlated with components of metabolic syndrome, body mass index (BMI), smoking, and TSH levels. In the nonnodular thyroid group, thyroid volume was also positively related to serum insulin and HOMA-IR, whereas a negative correlation between thyroid volume and leptin was identified in the nodular thyroid group. The goiter was identified in 12.3% of subjects. Female gender, thyroid nodules, smoking, BMI, and levels of TSH were independent predictors for goiter. Thyroid nodules were found in 31.2% of participants. Female gender, higher TSH levels, and thyroid volume were independent risk factors for thyroid nodules. Conclusions. Female gender, thyroid nodules, smoking, BMI, and TSH levels were identified as potential predictors of goiter. Female gender, TSH levels, and thyroid volume predicted the presence of thyroid nodules.

Gender Disparity in the Relationship between Prevalence of Thyroid Nodules and Metabolic Syndrome Components: The SHDC-CDPC Community-Based Study.

The study is aimed to investigate the pathogenesis underlying the increased prevalence of thyroid nodule (TN) in different levels of metabolic syndrome (MetS) components and analyze the relationships between TN and MetS components. A total of 6,798 subjects, including 2201 patients with TN, were enrolled in this study. Anthropometric, biochemical, thyroid ultrasonographic, and other metabolic parameters were all measured. There was obviously sexual difference in the prevalence of TN (males 26.0%, females 38.5%, resp.). The prevalence of TN in hyperuricemia (45.7% versus 37.4%, P = 0.001), NAFLD (41.2% versus 36.4%, P < 0.05), and MetS (41.4% versus 35.4%, P < 0.001) groups was significantly increased only in females. Insulin resistance [OR = 1.31 (1.15, 1.49)], MetS [OR = 1.18 (1.03, 1.35)], and diabetes [OR = 1.25 (1.06, 1.48)] were all independent risk factors for TN in total subjects, whereas, after stratified analysis of gender, MetS [OR = 1.29, (1.09, 1.53)] and diabetes [OR = 1.47, (1.17, 1.84)] are still strongly and independently associated with the higher risks of TN in female subjects, but not in males. Our results suggest that the components of MetS might associate with the higher risks of TN in women than in men, but further cohort study of this gender disparity in the association between TN and MetS is required.

Thyroid nodule prevalence among young residents in the evacuation area after fukushima daiichi nuclear accident: Results of preliminary analysis using the official data

Introduction: The nuclear accidents at Fukushima Daiichi Nuclear Power Plant released more than 10 EBq (exabecquerel) of the radionuclides into the atmosphere. A primary health concern after the nuclear accident is the internal exposure of children to radioactive iodines, which are known to accumulate in the thyroid, and to cause neoplasm. Fortunately, studies conducted so far have shown that the thyroid doses from internal exposure to 131I were low, and therefore, any excess risk of thyroid cancer among residents is considered unlikely to be detected in the future. Data and Analysis: Approximately half a year after the accident, the Fukushima Health Management Survey was started. It includes the thyroid screening survey using ultrasonography and a program to estimate the individual radiation dose of residents and evacuees. Results and Discussions: The first-round thyroid survey, which was conducted during the period 2011–2013, covered 300,476 young residents, approximately 82% of residents eligible for the survey, and found thyroid nodules in 3990 examinees. The prevalence of nodules in the evacuation zone was similar to that in the nonevacuation zone. The second-round survey, which was conducted during the period 3–6 years after the accident, detected 3788 participants with thyroid nodules among 270,511 examinees (approximately 71% of eligible residents). The prevalence of thyroid nodules in the evacuation zone was significantly higher than that in the rest of area (relative risk = 1.32; 95% confidence interval = 1.19, 1.45). Conclusion: Further studies are necessary to evaluate the scientific significance of present findings.

Preoperative diagnostics in differentiated thyroid carcinoma

The preoperative diagnosis of differentiated thyroid carcinomas (DTC) is particularly challenging in view of the high prevalence of thyroid nodules in the general population. Incidental diagnosis of DTC, on the other hand, can lead to reoperations and increased risk of morbidity. This study aimed to assess the prediction value of preoperative DTC dignity assessment and it's impact on surgical approaches. We retrospectively reviewed 107 cases of DTC and subdivided them in three groups based on the preoperative dignity assessment: suspected malignancy (SM), unclear dignity (UD), and incidental findings (IF). The group differences were investigated in terms of diagnostic methods, findings, and impact on the subsequent surgical approach. The patient groups consisted of n = 51 (SM), n = 32 (UD), and n = 24 (IF). The tumor size, T staging, and ultrasound (US) assessment had the largest impact on the dignity classification (each p < 0.001). Scintigraphy was performed in 80 % of the patients, fine-needle aspiration cytology (FNAC) in 28 %. Hypofunction at scintigraphy (p < 0.001) and cytology results (p < 0.01) were identified as significant predictors for group assignment. Other significant factors were the frequency of the US documentation of nodule characteristics (p < 0.001) and malignancy criteria (p < 0.01) as well as reduced thyroid-stimulating hormone (TSH) levels (p < 0.01). Frozen section (p < 0.001) and total thyroidectomy (p < 0.01) at initial surgery were performed significantly more often in the MV group. Reoperations were significantly more frequent in the IF group (p < 0.001). A relevant number of DTC cases was diagnosed incidentally, leading to significantly more frequent reoperations. A more systematic diagnostic approach with complete documentation of the findings according to current guidelines should be pursued.

The Prevalence of Thyroid Nodules and Their Association with Metabolic Syndrome Risk Factors in a Moderate Iodine Intake Area.

To investigate the prevalence of thyroid nodules (TNs) and to evaluate the association between TNs and metabolic syndrome (MetS) in the moderate iodine intake area of Jiangsu, China. A cross-sectional study was carried out in a Chinese community-based epidemiological investigation from January to December 2014. A questionnaire was completed by 6494 subjects (2427 men and 4067 women). Thyroid ultrasound was performed by using a 7.5-MHz linear probe. MetS was defined according to the 2006 International Diabetes Federation criteria. The prevalence of TNs in the study population was 17.7% (12.9% for men and 20.6% for women) and significantly higher in subjects with MetS [MetS(+)] than in those without MetS [MetS(-)] (25.8% vs. 15.5%, χ2 = 78.471, P < 0.001). Binary logistic regression indicated that (in addition to female sex and increased age) increased fasting plasma glucose (FPG), waist circumference (WC), hypertension, and smoking were positively associated with the prevalence of TNs. Our findings indicated a positive association between MetS and formation of TNs. Increased WC and FPG, as well as hypertension, might increase the prevalence of TNs.

Thyroid nodule update on diagnosis and management.

Thyroid nodules are common. The clinical importance of thyroid nodules is related to excluding malignancy (4.0 to 6.5% of all thyroid nodules), evaluate their functional status and assess for the presence of pressure symptoms. Incidental thyroid nodules are being diagnosed with increasing frequency in the recent years with the use of newer and highly sensitive imaging techniques. The high prevalence of thyroid nodules necessitates that the clinicians use evidence-based approaches for their assessment and management. New molecular tests have been developed to help with evaluation of malignancy in thyroid nodules. This review addresses advances in thyroid nodule evaluation, and their management considering the current guidelines and supporting evidence.

Prevalence of Thyroid Nodules and Its Relationship with Iodine Status in Shanghai: a Population-based Study

ObjectiveThis study was designed to evaluate the prevalence of thyroid nodules (TNs) and its relationship with urine iodine concentrations (UICs) after the regional rapid economic growth and lifestyle changes. MethodsA cross-sectional survey was conducted in the general population aged 15-69 years. A questionnaire regarding general and personal characteristics and relevant information was administered. Ultrasonography of the thyroid was performed, and serum triiodothyronine (T3), tetraiodothyronine (T4), serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), free tetraiodothyronine (FT4), thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb), and TSH receptor antibody (TRAb) levels were measured for each individual subject. ResultsThe prevalence rates of TNs in the whole population, females and males were 27.76%, 34.04%, and 21.60%, respectively. The prevalence of multiple nodules increased with age, whereas the prevalence peaks differed between males and females. The median UICs in the whole population and females with non-TNs were higher than those of subjects with TNs (P=0.0035, P=0.0068). The median UICs in subjects with a single TN were higher than those in subjects with multiple TNs (P=0.0164, P=0.0127). The result showed a U-shaped curve relationship between UIC and prevalence of TNs. The prevalence of TNs was the lowest when the UIC was 140-400 μg/L. ConclusionThe prevalence of TNs was nearly 30% and increased with age. The relationship between UIC and prevalence of TNs is U-shaped, with an increase in risk when the UIC was <140 μg/L and >400 μg/L. Very low or high UIC levels need attention and correction.

Can Elastography Predict Growth of Incidental Thyroid Nodules? A Pilot Two-Year Follow-Up Study.

The objective of this study was to examine the ultrasonography (US) and ultrasound elastography (USE) features of thyroid incidentalomas in a population exposed to iodine deficiency and to investigate whether baseline elasticity scores (ES) predicted changes in thyroid nodule US characteristics. We conducted a two-year follow-up pilot study of thyroid incidentalomas by US and USE. One sonographer performed the US and USE examination on the same apparatus at baseline and at follow-up. We evaluated 83 incidental thyroid nodules detected in a population study. The follow-up period saw no change in median thyroid nodule diameter (p = 0.18) or in the prevalence of thyroid nodule US characteristics (hypoechoic: p = 0.05; solid nodule: p = 1.00; microcalcifications: p = 0.55). Individual changes in thyroid nodule diameter (>20%) were seen in 23% (11% had decreased, and 12% had increased in diameter). Changes in ES were frequently observed; 37% changed from ES A + B to ES C + D, and 27% changed from ES C + D to ES A + B. In a multivariate logistic regression model, we found no association between baseline ES and individual changes in nodule size. In an area with mild iodine deficiency and a high prevalence of thyroid nodules, thyroid USE performed on thyroid incidentalomas did not predict individual changes in thyroid nodule size.

Prevalence of hypothyroidism and thyroid nodule in chronic hemodialysis Iranian patients.

End stage renal disease (ESRD) reasons several changes in the function of thyroid gland as; lower levels of thyroid hormones, altered hormone metabolism, and increased iodine storage. The aim of this study was to evaluate the prevalence of nodular goiter and hypothyroidism in hemodialysis (HD) patients compared with normal population. This cross-sectional study was conducted among HD patients and healthy people as the control group for thyroid function evaluation. Thyroid gland was evaluated by physical examination and ultrasonography. Blood level of FT3, FT4, TSH, TPO Ab, and urinary iodine excretion were checked in both groups. Data were analyzed using SPSS-17 and P-value less than 0.05 was considered as the significance level. Eighty six HD patients (57.2 ± 17.2 mean age, 48 men) and 86 healthy people (56.6 ± 16.8 mean age, 48 men) were enrolled in this study. Goiter was confirmed by physical examination in 29.0% of the HD patients and 12.8% of the control group (P = 0.04). Nodular goiter that was shown by ultrasonography was found in 27.9% and 3.5% of the HD and control groups, respectively (P = 0.01). HD patients had a higher frequency of reduced FT3 (40.9% vs. 4.6%, P < 0.01) and increased TSH (18.6% vs. 8.1%, P < 0.03(. TPO Ab was positive in 15.1% of the HD and 11.6% of the control groups (P = 0.14). The high incidence of nodular goiter and hypothyroidism in ESRD patients shows that screening for thyroid dysfunction and goiter, using appropriate laboratory tests, should be considered in evaluations of ESRD patients.

An Occupational Study in Nurses: Prevalence of Thyroid Nodules and Cancer in Comparison to Health Check-up Female.

Objectives.It is known that a great extent of radiation is emitted from the medical instruments used in hospitals and that radiation exposure can cause thyroid cancer. However, the correlation between occupational radiation exposure in hospitals and thyroid disease is not extensively recognized.Methods.The subjects of the study were female nurses, who worked at a single hospital and female, who had undergone a health examination at the same hospital during the same period. The 1,024 nurses and 2,631 healthy women were enrolled for the present study. All the participants were screened using thyroid ultrasonography, and fine-needle aspiration & cytology was performed on potentially malignant nodules.Results.Thyroid nodules were present in 315 nurses (30.8%) and 1,023 health check-up female (38.9%). Typically, 107 nurses (10.4%) and 201 health check-up female (7.6%) had suspicious nodule and were further tested with ultrasonography guided fine-needle aspiration & cytology. The 16 nurses (1.6%) and 38 health check-up female (1.4%) were diagnosed with thyroid cancer. The prevalence of thyroid nodules was enhanced in both the groups and a significant increase was noted in health check-up female group (P<0.05); however, no difference was seen in the incidence of thyroid cancer in both the groups (P>0.05).Conclusion.In our study, working in a hospital does not increase the prevalence of thyroid nodules or thyroid cancer.

Noninvasive In Vivo Imaging and Biologic Characterization of Thyroid Tumors by ImmunoPET Targeting of Galectin-3.

The high prevalence of thyroid nodules in the adult population and the relatively low incidence of thyroid cancer make the preoperative identification of malignant lesions challenging. The β-galactoside-binding protein galectin-3 is widely expressed in well-differentiated thyroid carcinomas, but not in normal thyrocytes and benign thyroid nodules. This molecule offers a candidate biomarker to improve thyroid cancer diagnosis. Here we report the development of an immunoPET approach for noninvasive imaging of thyroid cancer. The method employs a (89)Zr-labeled mAb to galectin-3, which shows high specificity and binding affinity in vitro Reliable and specific immunoPET imaging was obtained of thyroid cancer in vivo in murine xenograft models of human thyroid cancer. Our findings provide a method to improve the clinical management of patients with thyroid nodules while reducing unnecessary surgery and social costs. Cancer Res; 76(12); 3583-92. ©2016 AACR.

Comparison of thyroid nodule prevalence in two population-based studies in Bulgaria: 2006 and 2012

Comparison of thyroid nodule prevalence in two population-based studies in Bulgaria: 2006 and 2012

Comprehensive Survey Results of Childhood Thyroid Ultrasound Examinations in Fukushima in the First Four Years After the Fukushima Daiichi Nuclear Power Plant Accident.

Thyroid nodules and cancers are rare in children compared with adults. However, after the 1986 Chernobyl Nuclear Power Plant accident, a rapid increase in childhood thyroid cancer was observed. To avoid any confusion and misunderstanding of data obtained in Fukushima after the 2011 nuclear accident, baseline prevalence of thyroid nodules and cancers should be carefully assessed with standardized criteria systematically, and comprehensively applied to the population perceived to be at risk. Under the official framework of the Fukushima Health Management Survey, the thyroids of children in Fukushima were examined using ultrasound, and the results collected in the first four years after the nuclear accident were analyzed in order to establish a baseline prevalence of childhood thyroid abnormalities, especially cancer. Of 367,685 people aged 18 years or younger as of April 1, 2011, who were living in Fukushima Prefecture at the time of the accident, 300,476 underwent thyroid ultrasound screening. Of those, 2108 subjects with thyroid nodules were further examined using an advanced ultrasound instrument, with standardized criteria applied to determine the need for fine-needle aspiration cytology (FNAC). FNAC results determined the need for surgery and histological confirmation of the cytological diagnosis. Of the 2108 rescreened subjects, 543 underwent FNAC, of whom 113 were diagnosed with malignancy or suspected malignancy. Subsequently, 99 patients underwent surgical resection, revealing 95 cases of papillary thyroid cancer, three poorly differentiated cancers, and one benign nodule. The overall prevalence of childhood thyroid cancer in Fukushima was determined to be 37.3 per 100,000 with no significant differences between evacuated and non-evacuated areas. Thyroid cancer patients had external exposure estimates of <2.2 mSv during the first four months. The high prevalence of childhood thyroid cancer detected in this four-year study in Fukushima can be attributed to mass screening. It clearly exceeds what is found incidentally anywhere else. Direct comparisons with any other results, even those from cancer registries, are not meaningful because of differences in methodology.

Research progress of thyroid imaging reporting and data system (TIRADS)

The prevalence of thyroid nodules in population is increasing around the world.To categorize thyroid nodules and stratify their malignant risk, thyroid imaging reporting and data system(TIRADS)was developed 6 years ago based on US , which is similar to breast imaging reporting and data system (BI-RADS). This paper aims at summarizing the particular content of kinds of TIRADS proposed by different researcher, clinic value of the application of TIRADS, the research status of TIRADS application, as well as the prospect of TIRADS based on CT and MRI.

Retraction Note: Thyroid nodules update in diagnosis and management.

[This retracts the article DOI: 10.1186/s40842-015-0011-7.].

The Prevalence of Thyroid Nodules and an Analysis of Related Lifestyle Factors in Beijing Communities.

Thyroid nodules (TNs) have annual increasing trends worldwide, and large-scale investigations on the prevalence of TNs in Beijing communities have not been conducted since the introduction of salt iodization in 1995. We performed a cross-sectional study to determine the prevalence of TNs, their epidemiological characteristics, and their correlation with lifestyle factors. A total of 6324 permanent residents aged 18 years or older (mean age, 52.15 ± 11.58 years) from seven representative communities in Beijing were included in the analyses. Once informed consent was obtained, the subjects were asked to complete questionnaires, a physical examination, and thyroid ultrasound. A total of 3100 cases had TNs. The overall prevalence rate was 49.0%, and the age-standardized prevalence was 40.1%, which increased significantly as age increased (p < 0.001). The prevalence was significantly higher in females compared to males (p < 0.001), and it was significantly higher among female current smokers and former smokers compared to non-smokers (p = 0.007). There was no correlation between alcohol consumption and TNs, and there were no significant differences in the prevalence among different groups of taste preference. The prevalence decreased with an increased frequency of seafood intake (p = 0.015) and with higher literacy levels (p < 0.001). The Cochran–Armitage trend test showed that the prevalence significantly increased with decreased physical labor and exercise intensity (p < 0.001, p = 0.009). Logistic regression analysis showed that age (Odds ratio (OR) = 1.039 (1.034–1.044), p < 0.001), the female sex (OR = 1.789 (1.527–2.097)), Body mass index (BMI) (OR = 1.019 (1.005–1.034)), and current smoking habits (OR = 1.246 (1.046–1.483)) were independent risk factors for TNs. Our findings indicate that there is a high prevalence of TNs in Beijing, with a higher prevalence in females than in males. Moreover, the prevalence increases as age increases. Smoking and BMI are independent risk factors for TNs. Therefore, intervention against smoking and weight loss might help reduce the risk of TN occurrence.