Ultrasonographic screening for detection of thyroid cancer in patients with Graves’ disease

Kim, Won; Han, Seong-Min; Kim, Tae Yong; Nam-Goong, Il Seong; Gong, Gyungyub; Lee, Ho Kyu; Hong, Suck Joon; Shong, Young Kee

doi:10.1111/j.1365-2265.2004.02043.x

Cited by 95 publications

(64 citation statements)

References 34 publications

(44 reference statements)

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“…Patients with thyroid autoimmune diseases were considered separately, as associations with papillary thyroid cancer have been reported for both GD and HT (29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39).…”

Section: Discussionmentioning

confidence: 99%

Male sex, single nodularity, and young age are associated with the risk of finding a papillary thyroid cancer on fine-needle aspiration cytology in a large series of patients with nodular thyroid disease

Rago

Fiore²,

Scutari³

et al. 2010

European Journal of Endocrinology

133

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Objective: To evaluate the risk of papillary thyroid carcinoma (PTC) at fine-needle aspiration (FNA) cytology in 34 120 patients. Results: False positive and false negative rates of FNA cytology were 1.2 and 1.8% in comparison with the histology in 3406 nodules from 3004 patients who underwent surgery. PTC (901 cases) was more frequent in solitary nodule (SN; 446/13 549, 3.3%) than in multinodular goiter (MNG; 411/19 923, 2%, c 2 Z48.8; P!0.0001), and in males (209/6382, 3.3%) than in females (648/26 945, 2.40%, c 2 Z15.58; P!0.0001). PTC prevalence in Graves' disease (GD; 13/286, 4.5%) and Hashimoto's thyroiditis (HT; 31/508, 6.1%) was higher than in SN, this difference being significant in HT (c 2 Z8.7; PZ0.003), but not in GD (c 2 Z1.6; PZ0.2). Using the multiple logistic regression analysis, independent risk predictors of PTC were determined, which were younger age (odds ratio (OR)Z0.97, confidence interval (CI) 0.964-0.974; P!0.0001), male gender (ORZ1.44, CI 1.231-1.683; P!0.0001), and SN versus MNG (ORZ0.63, CI 0.547-0.717; P!0.0001). The individual risk predictivity was highly improved by including serum TSH in the prediction model, which was measured at FNA in 11 919 patients. Conclusion: A cytology suspicious or indicative of PTC was associated with younger age, male gender, and solitary versus multiple nodularity. These clinical parameters, together with serum TSH, may allow formulation of an algorithm that could be usefully applied to predict the risk of PTC in individual patients when cytology does not give a diagnostic result.

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Section: Discussionmentioning

confidence: 99%

Male sex, single nodularity, and young age are associated with the risk of finding a papillary thyroid cancer on fine-needle aspiration cytology in a large series of patients with nodular thyroid disease

Rago

Fiore²,

Scutari³

et al. 2010

European Journal of Endocrinology

133

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“…detected thyroid nodule by palpation in 9.4% of the patients (23/245) and by thyroid ultrasonography in 35.1% of the patients (6/245) in a prospective study which they conducted with 245 Graves patients. Fifty percent of these patients (43/86) had solitary nodules and 50% (43/86) had multiple nodules (11).…”

Section: Resultsmentioning

confidence: 99%

Thyroid nodules and thyroid cancer in Graves’ disease

Tam

Kaya

Kılıç

et al. 2014

Arq Bras Endocrinol Metab

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Objective: The frequency of thyroid nodules accompanying Graves' disease and the risk of thyroid cancer in presence of accompanying nodules are controversial. The aim of this study was to evaluate the frequency of thyroid nodules and the risk of thyroid cancer in patients operated because of graves' disease. Subjects and methods: Five hundred and twenty-six patients in whom thyroidectomy was performed because of Graves' disease between 2006 and 2013 were evaluated retrospectively. Patients who had received radioactive iodine treatment and external irradiation treatment in the neck region and who had had thyroid surgery previously were not included in the study. Results: While accompanying thyroid nodule was present in 177 (33.6%) of 526 Graves' patients, thyroid nodule was absent in 349 (66.4%) patients. Forty-two (8%) patients had thyroid cancer. The rate of thyroid cancer was 5.4% (n = 19) in the Graves' patients who had no nodule, whereas it was 13% (n = 23) in the patients who had nodule. The risk of thyroid cancer increased significantly in presence of nodule (p = 0.003). Three patients had recurrence. No patient had distant metastasis. No patient died during the follow-up period. Conclusions: Especially Graves' patients who have been decided to be followed up should be evaluated carefully during the follow-up in terms of thyroid cancer which may accompany. Arq Bras Endocrinol Metab. 2014;58(9):933-8 Keywords Graves' disease; thyroid nodules; thyroid cancer RESUMO Objetivo: A frequência da ocorrência de nódulos tiroidianos acompanhando a doença de Graves e o risco de câncer de tiroide na presença desses nódulos é controversa. O objetivo deste estudo foi avaliar a frequência de nódulos tiroidianos e o risco de câncer de tiroide em pacientes operados por doença de Graves. Sujeitos e métodos: Quinhentos e vinte e seis pacientes anteriormente submetidos à tiroidectomia por doença de Graves entre 2006 e 2013 foram avaliados retrospectivamente. Os pacientes que receberam tratamento com iodo radioativo e irradiação externa da região do pescoço e que anteriormente passaram por cirurgia de tiroide não foram incluídos no estudo. Resultados: Enquanto os nódulos de tiroide se apresentaram em 177 (33,6%) dos 526 pacientes com doença de Graves, eles estiveram ausentes em 349 (66,4%) pacientes. Um total de 42 (8%) dos pacientes teve câncer de tiroide. A ocorrência de câncer de tiroide foi 5,4% (n = 19) nos pacientes com doença de Graves que não apresentaram nódulos, e 13% (n = 23) nos pacientes com nódulos. O risco de câncer de tiroide aumentou significativamente na presença de nódulos (p = 0,003). Três pacientes apresentaram recidivas. Nenhum paciente apresentou metástase distante e nenhum paciente veio a óbito durante o período de acompanhamento. Conclusões: Pacientes com doença de Graves devem ser avaliados cuidadosamente no acompanhamento para a possível ocorrência de câncer de tiroide. Arq Bras Endocrinol Metab. 2014;58(9):933-8 Descritores Doença de Graves; nódulos tiroidianos; câncer de tiroide

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“…Lymph nodes involvement was found in up to 61.5 % of the patients [ 8 , 31 ] and the incidence of locally advanced cancers was signifi cantly higher in older patients [ 44 ] . However, some studies report discordant results or do not highlight the aggressive characteristics of thyroid carcinomas in Table 1 Incidence of thyroid carcinoma in hyperthyroid patients (Graves', autonomous adenoma, toxic multinodular goiter).…”

Section: Aggressivenessmentioning

confidence: 99%