Alshahrani Awad, Alshehri Sameerah, Ajwah Ibrahim, Alotay Faisal, Alqahtani Faisal S
Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.
Department of Medicine, Ministry of National Guard-Health Affairs, Riyadh, SAU.
Cureus. 2024 Dec 20;16(12):e76068. doi: 10.7759/cureus.76068. eCollection 2024 Dec.
Background Thyroid nodules are typically an initial sign of thyroid cancer (TC) and require evaluation by thyroid ultrasonography. Additional measures, such as fine needle aspiration, may be necessary depending on the level of malignancy risk. This study aims to comprehensively analyze TC clinical, radiological, and histopathological characteristics in a cohort of Saudi patients. Methods A retrospective chart review was carried out on TC patients who were being followed up at a tertiary care center in the Riyadh region of Saudi Arabia. The study included all patients aged 15 years and above diagnosed between 2013 and 2022 with adequate histopathological data. Statistical analysis used: SPSS v.27 was used for the data analysis. Results In total, 272 patients were included in the study, with a mean age of 47.23 ± 12.6 years. Of these, 222 (81.6%) were females. Nearly two-thirds of the affected patients had a body mass index (BMI) exceeding 25. The most common histological type of cancer was classical papillary thyroid carcinoma, accounting for 58.5% of cases. The average tumor size was 2.52 cm. The majority of patients presented with TNM stage I (86%), while one-fourth of the study population had thyroid imaging reporting and data systems (TI-RADS) 6 and Bethesda V. metastatic lymph nodes were predominantly among males (57.8%), and those younger than 50 years of age. The extrathyroidal extension was observed in 72% of tall-cell papillary thyroid carcinomas and 62.5% of oncocytic variant papillary thyroid carcinomas, compared to less than 50% in other subtypes (p < 0.001). Conclusions In our study, TC primarily affects obese middle-aged women. However, male gender and younger age are significant risk factors for lymph node involvement. Additionally, histopathological subtypes, rather than clinical parameters, are more likely to increase the risk of extrathyroidal extension. Given the conflicting data regarding clinical risk factors associated with the development of TC, lymph node metastasis, and extrathyroidal extension, further research is needed to clarify these discrepancies.
背景 甲状腺结节通常是甲状腺癌（TC）的初始体征，需要通过甲状腺超声进行评估。根据恶性风险水平，可能需要采取其他措施，如细针穿刺。本研究旨在全面分析一组沙特患者的TC临床、放射学和组织病理学特征。方法 对沙特阿拉伯利雅得地区一家三级医疗中心正在接受随访的TC患者进行回顾性病历审查。该研究纳入了所有在2013年至2022年期间确诊、年龄在15岁及以上且有充分组织病理学数据的患者。统计分析 使用：SPSS v.27进行数据分析。结果 本研究共纳入272例患者，平均年龄为47.23±12.6岁。其中，222例（81.6%）为女性。近三分之二的患病患者体重指数（BMI）超过25。最常见的癌症组织学类型是经典型乳头状甲状腺癌，占病例的58.5%。平均肿瘤大小为2.52厘米。大多数患者表现为TNM I期（86%），而四分之一的研究人群甲状腺影像报告和数据系统（TI-RADS）为6类以及贝塞斯达V类。转移性淋巴结主要见于男性（57.8%）以及年龄小于50岁的人群。在高细胞型乳头状甲状腺癌中，72%观察到甲状腺外侵犯，在嗜酸细胞变异型乳头状甲状腺癌中为62.5%，而在其他亚型中低于50%（p<0.001）。结论 在我们的研究中，TC主要影响肥胖的中年女性。然而，男性性别和较年轻年龄是淋巴结受累的重要危险因素。此外，组织病理学亚型而非临床参数更有可能增加甲状腺外侵犯的风险。鉴于关于与TC发生、淋巴结转移和甲状腺外侵犯相关的临床危险因素的数据存在冲突，需要进一步研究来澄清这些差异。
