Alqahtani Saad M, Albalawi Hamed I, Alalawi Yousef S, AlFattani Areej A, Al-Sobhi Saif S
Department of Surgery, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia.
Department of Surgery, King Fahad Specialist Hospital, Tabuk, Saudi Arabia.
Gland Surg. 2024 Apr 29;13(4):470-479. doi: 10.21037/gs-24-12. Epub 2024 Apr 18.
The association between malignancy risk and nodule size in indeterminate thyroid nodules (ITNs) remains controversial. Thus, we aimed to explore the impact of nodule size as a predictor of cancer in patients with ITNs.
This cross-sectional study assessed 113 patients who underwent surgical intervention for ITNs, comparing two groups based on nodule size (≥4 or <4 cm). The correlation between nodule size and malignancy risk was examined. Other variables of interest included demographics, thyroid-stimulating hormone (TSH) levels, type of surgery, and ultrasound features.
Of the 113 patients, 88.5% were aged <55 years, 76.1% were women, and 65.5% had nodules <4 cm. Mean nodule size was 3.4±2.3 cm. There was no significant correlation between malignancy risk and nodule size (P=0.55). An association was observed between <4 cm nodules and elevated TSH levels (P=0.03) and between ≥4 cm nodules and the presence of hypervascularity (P=0.04). Nodules <4 cm were more likely to have extrathyroidal extension, lymphovascular invasion, and positive margins than those ≥4 cm; however, this was not significant.
Our findings showed no association between nodule size and malignancy risk, suggesting that size alone is not a predictor of cancer development. Further prospective studies are required to confirm these results.
甲状腺结节性质不明（ITNs）患者中，恶性风险与结节大小之间的关联仍存在争议。因此，我们旨在探讨结节大小对ITNs患者癌症预测的影响。
这项横断面研究评估了113例行ITNs手术干预的患者，根据结节大小（≥4或<4 cm）将其分为两组进行比较。研究了结节大小与恶性风险之间的相关性。其他感兴趣的变量包括人口统计学特征、促甲状腺激素（TSH）水平、手术类型和超声特征。
113例患者中，88.5%年龄<55岁，76.1%为女性，65.5%的结节<4 cm。平均结节大小为3.4±2.3 cm。恶性风险与结节大小之间无显著相关性（P=0.55）。观察到<4 cm结节与TSH水平升高之间存在关联（P=0.03），≥4 cm结节与存在高血运之间存在关联（P=0.04）。<4 cm的结节比≥4 cm的结节更易出现甲状腺外侵犯、脉管侵犯和切缘阳性；然而，差异无统计学意义。
我们的研究结果表明结节大小与恶性风险之间无关联，提示仅凭大小不能预测癌症的发生。需要进一步的前瞻性研究来证实这些结果。
