Bestepe Nagihan, Ozdemir Didem, Baser Husniye, Ogmen Berna, Sungu Nuran, Kilic Mehmet, Ersoy Reyhan, Cakir Bekir
Ankara Ataturk Educational and Research Hospital, Department of Endocrinology and Metabolism, Ankara, Turkey.
Yildirim Beyazit University, School of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey.
Arch Endocrinol Metab. 2019 Mar 21;63(4):337-344. doi: 10.20945/2359-3997000000113.
We aimed to determine the roles of preoperative thyroid nodule diameter and volume in the prediction of malignancy.
The medical records of patients who underwent thyroidectomy between January 2007 and December 2014 were reviewed. The nodule diameters were grouped as < 1 cm, 1-1.9 cm, 2-3.9 cm and ≥ 4 cm, and volume was grouped as > 5 cm3, 5-9.9 cm3 and > 10 cm3. ROC (Receiver Operating Characteristic) curve analysis was performed to find the optimal cutoff value of diameter and volume that can predict malignancy.
There were 5561 thyroid nodules in 2463 patients. Five hundred and forty (9.7%) nodules were < 1 cm, 2,413 (43.4%) were 1-1.9 cm, 1,600 (28.8%) were 2-3.9 cm and 1,008 (18.1%) were ≥ 4 cm. Malignancy rates were 25.6%,10.6%, 9.7% and 8.5% in nodules < 1 cm, 1-1.9 cm, 2-3.9 cm and ≥ 4 cm, respectively. When classified according to volume, 3,664 (65.9%) nodules were < 5 cm3, 594 (10.7%) were 5-9.9 cm3 and 1,303 (23.4%) were ≥ 10 cm3. The malignancy rates were 12.7%, 11.4% and 7.8% for the nodules < 5 cm3, 5-9.9 cm3 and ≥ 10 cm3, respectively (p < 0.001). In ROC curve analysis, an optimal cutoff value for diameter or volume that can predict malignancy in all thyroid nodules or nodules ≥ 4 cm could not be determined.
In this surgical series, malignancy risk did not increase with increasing nodule diameter or volume. Although the volume of malignant nodules ≥ 4 cm was higher than that of benign nodules ≥ 4 cm, there was no optimal cutoff value. The diameter or volume of the nodule cannot be used to predict malignancy or decide on surgical resection.
我们旨在确定术前甲状腺结节直径和体积在预测恶性肿瘤方面的作用。
回顾了2007年1月至2014年12月期间接受甲状腺切除术患者的病历。结节直径分为<1 cm、1 - 1.9 cm、2 - 3.9 cm和≥4 cm，体积分为>5 cm³、5 - 9.9 cm³和>10 cm³。进行ROC（受试者工作特征）曲线分析以找出可预测恶性肿瘤的直径和体积的最佳临界值。
2463例患者中有5561个甲状腺结节。540个（9.7%）结节<1 cm, 2413个（43.4%）为1 - 1.9 cm, 1600个（28.8%）为2 - 3.9 cm，1008个（18.1%）≥4 cm。<1 cm、1 - 1.9 cm、2 - 3.9 cm和≥4 cm结节的恶性率分别为25.6%、10.6%、9.7%和8.5%。按体积分类时，3664个（65.9%）结节<5 cm³，594个（10.7%）为5 - 9.9 cm³，1303个（23.4%）≥10 cm³。<5 cm³、5 - 9.9 cm³和≥10 cm³结节的恶性率分别为12.7%、11.4%和7.8%（p<0.001）。在ROC曲线分析中，无法确定可预测所有甲状腺结节或≥4 cm结节恶性肿瘤的直径或体积的最佳临界值。
在本手术系列中，恶性风险并未随结节直径或体积的增加而增加。虽然≥4 cm恶性结节的体积高于≥4 cm良性结节，但没有最佳临界值。结节的直径或体积不能用于预测恶性肿瘤或决定手术切除。
