Risk Factors Associated with Benign and Malignant Thyroid Nodules in Autoimmune Thyroid Diseases

Abstract

Objectives. Assess the prevalence of thyroid nodules and predictors of malignant origin in patients with autoimmune thyroid diseases. Patients and Methods. Retrospective study including 275 patients, 198 with Graves' disease and 77 with Hashimoto's thyroiditis. Clinical and demographical data, ultrasonographical nodule characteristics, total thyroid volume and histological characteristics were recorded. Results. Graves' disease: the prevalence of thyroid nodules and thyroid carcinoma were 27.78% and 5.05%, respectively. Older age (OR = 1.054; 95% CI = 1.029–1.080) and larger thyroid volumes (OR = 1.013; 95% CI = 1.003–1.022) increased the chance of nodules. Younger age (OR = 1.073; 95% CI = 1.020–1.128) and larger thyroid volume (OR = 1.018; 95% CI = 1.005–1.030) predicted thyroid carcinoma. Hashimoto's thyroiditis: the prevalence of thyroid nodules and carcinomas were 50.7% and 7.8%, respectively. Nodules were predicted by thyroid volume (OR = 1.030; 95% CI = 1.001–1.062). We found higher number of nodules in patients with thyroid carcinoma than in those with benign nodules (3 versus 2; P = 0.03). Patients with Hashimoto's thyroiditis presented nodules more frequently than patients with Graves' disease (50.65% versus 27.28%; P < 0.001), while the prevalence of carcinoma was similar (P = 0.751). Conclusions. Larger goiter was associated with carcinoma in Graves' disease and Hashimoto's thyroiditis. Younger patients presented higher risk of papillary thyroid carcinoma in Graves' disease. The prevalence of carcinoma was similar in both conditions.

A comparative study of nuclear 8-hydroxyguanosine expression in Autoimmune Thyroid Diseases and Papillary Thyroid Carcinoma and its relationship with p53, Bcl-2 and Ki-67 cancer related proteins

“…with AITD than in those without AITD and that they may be a 209 premalignant condition to PTC [20,21,22]. Our results, concerning 210 lymphoid cells, demonstrate unprecedently that these cells are 211 attacked by oxidative damage in PTC and AITD.…”

Thyroid nodules and thyroid cancer in Graves’ disease

“…The malignancy rate in these nodules varies between 10% and 46% (10). This rate is approximately 5% in the general population (12). While the annual incidence of clinical thyroid cancer in the general euthyroid population has been reported to be 0.5-8/100.000, it is 175/100.000 in Graves disease (13).…”

“…(14) reported this rate to be 3.6% (n = 12). This shows that malignancy is not always related with nodule (12). If these patients were treated only with antithyroid and/ or radioactive iodine, they would not have received an appropriate treatment because of accompanying thyroid cancer (15).…”

Evaluation the Relationship Between Thyroid Nodule Size with Malignancy and Accuracy of Fine Needle Aspiration Biopsy (FNAB)

“…Pinchot et al reported that thyroid carcinoma prevalence was higher in the elderly compared with others while Rosario and et al did not observe a significant difference between the age of the patients (6, 18). Nevertheless, some studies including ours, revealed that the prevalence of thyroid carcinoma is higher in the younger patients (19, 20). …”