Ruhaiyem Mead E, Al Khenizan Abdullah, Hussain Aneela
Department of Family Medicine and Polyclinic, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia.
J Family Med Prim Care. 2022 Dec;11(12):7602-7606. doi: 10.4103/jfmpc.jfmpc_2132_21. Epub 2023 Jan 17.
Thyroid cancer is the second most common cancer among women. This study was conducted to assess the yield of fine-needle aspiration (FNA) cytology of thyroid nodules in a primary care setting in Riyadh, Saudi Arabia.
In this retrospective cohort study, primary care patients of both genders with thyroid nodules who underwent FNA above the age of 18 years were enrolled. Patients with a prior history of cancer were excluded. The data was collected from the histopathology reports of FNAs done for thyroid nodules from January 01, 2002 to July 31, 2018.
We enrolled 263 patients in this study. The mean age of the study population was 41.3 years old (Standard deviation (SD) ± 10.1), 81.7% were females and 18.3% were males. The rate of abnormal ultrasound (US) was 16%. The mean thyroid-stimulating hormone (TSH) level was 2.3 mU/L (SD ± 5.9). Post-thyroidectomy, 17.5% had carcinoma on pathology reports. Among those who were diagnosed with thyroid cancer, 76.2% had papillary thyroid cancer, 21.4% had follicular thyroid cancer, and 2.4% had medullary thyroid cancer. The mean age for cancer diagnosis was 40 years old (SD ± 8). There was no significant association between FNA findings (benign/malignant) and age, gender, history of smoking, size of the nodule, or TSH level.
Thorough investigations including FNA should be considered for patients presenting with suspicious thyroid nodules, regardless of their size or the patients' gender. Access to such investigations and referrals to specialists should be available for primary care physicians.
甲状腺癌是女性中第二常见的癌症。本研究旨在评估沙特阿拉伯利雅得初级保健机构中甲状腺结节细针穿刺(FNA)细胞学检查的结果。
在这项回顾性队列研究中,纳入了年龄在18岁以上、患有甲状腺结节且接受FNA检查的初级保健男女患者。有癌症病史的患者被排除。数据收集自2002年1月1日至2018年7月31日对甲状腺结节进行FNA检查的组织病理学报告。
本研究共纳入263例患者。研究人群的平均年龄为41.3岁(标准差(SD)±10.1),女性占81.7%,男性占18.3%。超声(US)异常率为16%。促甲状腺激素(TSH)平均水平为2.3 mU/L(SD±5.9)。甲状腺切除术后,病理报告显示17.5%患有癌症。在那些被诊断为甲状腺癌的患者中,76.2%患有乳头状甲状腺癌,21.4%患有滤泡状甲状腺癌,2.4%患有髓样甲状腺癌。癌症诊断的平均年龄为40岁(SD±8)。FNA检查结果(良性/恶性)与年龄、性别、吸烟史、结节大小或TSH水平之间无显著关联。
对于出现可疑甲状腺结节的患者,无论结节大小或患者性别,都应考虑进行包括FNA在内的全面检查。初级保健医生应能够进行此类检查并转诊至专科医生。