Ajarma Khaled Y, Al-Faouri Ashraf F, Al Ruhaibeh Maysoon K, Almbaidien Feras A, Nserat Rima T, Al-Shawabkeh Abdallah O, Al-Sarihin Khaldon K, Al-Harazi Yousef A, Rbihat Haitham S, Aljbour Mohammad E
Consultant (Surgery), King Hussein Medical Center, Amman 11831, Jordan.
Senior Specialist (Pathology), King Hussein Medical Center, Amman 11831, Jordan.
Med J Armed Forces India. 2020 Jan;76(1):23-29. doi: 10.1016/j.mjafi.2018.05.001. Epub 2018 Jul 3.
It is generally believed that multinodular goiter (MNG) is associated with a lower risk of malignancy compared to solitary thyroid nodules (STN). This will be the null hypothesis in this retrospective study and we aim to prove or reject it.
Medical files and histopathology reports of 600 patients who underwent thyroidectomy over 4-year period were reviewed. Data including patient' age, gender, presentation, ultrasonography, FNAC, surgical procedures, final histopathologic diagnosis and stage of malignant tumors were collected and analyzed. The primary end point was assessment of risk of thyroid carcinoma in patients with MNG compared to those with STN. Secondary endpoints included demographic differences and prognosis.
There were 459 females (76.5%). Mean age was 44.3 ± 14.5 years (range 14-85). After exclusion of 33 patients, 224 (39.5%) had STN and 343 (60.5%) had MNG. The prevalence of thyroid cancer was 41.1% (92/224) in STN compared to 29.2% (100/343) in MNG (Chi-Square = 8.593, < 0.01). However, on multiple logistic regression analysis this correlation was found insignificant ( = 0.640). Only male gender ( = <0.000005) and preoperative impression of malignancy ( = 0.000082) were significantly associated with thyroid carcinoma.
The risk of thyroid carcinoma in STN and MNG was similar. Male gender was identified as a risk factor for thyroid cancer while age, number and size of nodules were not.
人们普遍认为，与甲状腺单发结节（STN）相比，结节性甲状腺肿（MNG）的恶性风险较低。这将是本回顾性研究中的零假设，我们旨在证明或推翻它。
回顾了600例在4年期间接受甲状腺切除术的患者的病历和组织病理学报告。收集并分析了包括患者年龄、性别、临床表现、超声检查、细针穿刺活检（FNAC）、手术方式、最终组织病理学诊断和恶性肿瘤分期等数据。主要终点是评估MNG患者与STN患者相比患甲状腺癌的风险。次要终点包括人口统计学差异和预后。
有459名女性（76.5%）。平均年龄为44.3±14.5岁（范围14 - 85岁）。排除33例患者后，224例（39.5%）患有STN，343例（60.5%）患有MNG。STN中甲状腺癌的患病率为41.1%（92/224），而MNG中为29.2%（100/343）（卡方检验=8.593，P<0.01）。然而，在多因素逻辑回归分析中，发现这种相关性不显著（P = 0.640）。只有男性性别（P = <0.000005）和术前恶性肿瘤印象（P = 0.000082）与甲状腺癌显著相关。
STN和MNG患甲状腺癌的风险相似。男性性别被确定为甲状腺癌的一个风险因素，而年龄、结节数量和大小则不是。
