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多结节性甲状腺肿患者甲状腺癌的发病率及类型

Frequency and Type of Thyroid Carcinoma in Patients With Multinodular Goiter.

作者信息

Amin Anam, Amjad Aalia, Farman Ghazi, Khaliq Saad U, Amin Laraib, Khan Mahnoor

机构信息

Department of Medicine, Northwest General Hospital and Research Center, Peshawar, PAK.

Department of Surgery, Khyber Teaching Hospital, Peshawar, PAK.

出版信息

Cureus. 2023 Apr 21;15(4):e37921. doi: 10.7759/cureus.37921. eCollection 2023 Apr.

Abstract

Background This study aimed to investigate the incidence and subtype of thyroid cancer in multinodular goitre (MNG) patients who underwent total thyroidectomy. Methodology A cross-sectional study was conducted at the Khyber Teaching Hospital, screening 207 MNG patients who received complete thyroidectomies between July and December 2022. The senior consultant diagnosed thyroid cancer based on a complete history, physical examination, and laboratory and radiological studies. Ultrasound-guided fine-needle aspiration cytology was performed by a senior consultant radiologist. Bethesda categories for all lesions were recorded. All patients underwent thyroidectomy, and the diagnosis of thyroid cancer was confirmed on histopathology.  Results A total of 207 patients were included in the study, with a mean age of 45.55 ± 8.75 years. Out of 207 patients, 24 (11.59%) were diagnosed with thyroid cancer. Out of 62 male patients, 15 (7.25%) had thyroid cancer. Out of 145 female patients, only nine had cancer (p < 0.001). Nine patients with thyroid cancer had a body mass index (BMI) below 18, compared to only five patients with a BMI of more than 30 kg/m. The difference in age distribution was not significant in our study (p = 0.102).  Conclusion  In conclusion, our study sheds light on the frequency and potential risk factors associated with thyroid cancer in patients with multinodular goiter. Our findings reveal that papillary thyroid carcinoma is the most commonly observed form of thyroid cancer in this patient population, with around 12 percent of patients diagnosed with thyroid cancer. Notably, our study highlights that male patients and those with a lower BMI may have a greater risk of developing thyroid cancer in the context of multinodular goiter. The findings of this study have important implications for the care and follow-up of MNG patients who receive total thyroidectomy. Further research is needed to investigate the type and prognosis of thyroid cancer in patients with MNG.

摘要

背景 本研究旨在调查接受全甲状腺切除术的多结节性甲状腺肿(MNG)患者中甲状腺癌的发病率和亚型。方法 在开伯尔教学医院进行了一项横断面研究,筛查了207例在2022年7月至12月期间接受全甲状腺切除术的MNG患者。高级顾问根据完整的病史、体格检查以及实验室和影像学检查诊断甲状腺癌。由高级顾问放射科医生进行超声引导下细针穿刺细胞学检查。记录所有病变的贝塞斯达分类。所有患者均接受了甲状腺切除术,并通过组织病理学确诊甲状腺癌。结果 本研究共纳入207例患者,平均年龄为45.55±8.75岁。在207例患者中,24例(11.59%)被诊断为甲状腺癌。在62例男性患者中,15例(7.25%)患有甲状腺癌。在145例女性患者中,只有9例患有癌症(p<0.001)。9例甲状腺癌患者的体重指数(BMI)低于18,而BMI超过30kg/m²的患者只有5例。在我们的研究中,年龄分布差异不显著(p=0.102)。结论 总之,我们的研究揭示了多结节性甲状腺肿患者中与甲状腺癌相关的频率和潜在风险因素。我们的研究结果显示,在该患者群体中,乳头状甲状腺癌是最常见的甲状腺癌形式,约12%的患者被诊断为甲状腺癌。值得注意的是,我们的研究强调,在多结节性甲状腺肿的情况下,男性患者和BMI较低的患者患甲状腺癌的风险可能更高。本研究结果对接受全甲状腺切除术的MNG患者的护理和随访具有重要意义。需要进一步研究来调查MNG患者中甲状腺癌的类型和预后。

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