Gitti Sama Atta, Baha Al-den Saman Sarko
Department of Internal Medicine, University of Baghdad, Al-Kindy College of Medicine, Baghdad, Iraq.
Sci Rep. 2025 Jul 1;15(1):21851. doi: 10.1038/s41598-025-08156-2.
Thyroid nodules are common, as they are found in up to 8% of adults. These nodules are becoming increasingly prevalent, possibly because of the increased use of ultrasound imaging. These nodules are mostly benign but remain a source of concern for both physicians and patients due to the possibility of malignant transformation. The aim of this study was to assess the ability and usefulness of thyroid function tests in predicting ultrasound and FNA outcomes of thyroid nodules and therefore confirm or rule out the malignant potential of these nodules. In this case‒control, prospective study, one hundred patients who presented to the outpatient clinic from March 2022 to June 2024 for evaluation of thyroid nodules were included. Follow-up protocols included medical history review, physical examination, thyroid function tests, ultrasound imaging examination and fine needle aspiration if indicated. Data were analyzed using SPSS 25, and a p value less than 0.05 indicated statistical significance. 40% of patients who had thyroid nodules had normal thyroid function tests, 28% had subclinical hyperthyroidism, 22% had subclinical hypothyroidism, 8% had overt hypothyroidism according to laboratory findings, and 2% had overt hyperthyroidism according to laboratory findings. A higher-than-normal BMI was significantly associated with TIRADS 2 nodules (95% C. I 0.40-0.97, p value < 0.0001), and a low BMI was significantly associated with TIRADS 4 nodules (95% C. I 0.08-0.53, p value 0.04). High levels of TSH were significantly associated with TIRADS 2 nodules (95% C. I 0.52_1.11, p value < 0.0001), and low levels of TSH, despite normal T3 and T4 levels, were correlated with TIRADS 4 nodules (95% C. I -1.10_0.9, p value < 0.0001). Low levels of TSH, despite normal T3 and T4 levels, and cytological findings were associated with Bethesda 2 nodules, which are benign follicular neoplasms (95% c. I 1.08-1.44, p value < 0.0001. Most patients who had thyroid nodules had normal thyroid function tests; however, low TSH levels were significantly associated with ultrasound evidence of TIRAD 4 nodules and Bethesda 2 nodules according to FNA, and high TSH levels were significantly associated with ultrasound evidence of TIRADS 2 nodules.
甲状腺结节很常见，在高达8%的成年人中都能发现。这些结节越来越普遍，可能是因为超声成像的使用增加。这些结节大多是良性的，但由于存在恶变的可能性，仍然是医生和患者关注的焦点。本研究的目的是评估甲状腺功能测试在预测甲状腺结节的超声和细针穿刺活检（FNA）结果方面的能力和实用性，从而确认或排除这些结节的恶性潜能。在这项病例对照前瞻性研究中，纳入了2022年3月至2024年6月到门诊评估甲状腺结节的100名患者。随访方案包括病史回顾、体格检查、甲状腺功能测试、超声成像检查以及必要时的细针穿刺活检。使用SPSS 25对数据进行分析，p值小于0.05表示具有统计学意义。根据实验室检查结果，40%有甲状腺结节的患者甲状腺功能测试正常，28%有亚临床甲亢，22%有亚临床甲减，8%有显性甲减，2%有显性甲亢。高于正常的体重指数（BMI）与甲状腺影像报告和数据系统（TIRADS）2类结节显著相关（95%置信区间0.40 - 0.97，p值<0.0001），低BMI与TIRADS 4类结节显著相关（95%置信区间0.08 - 0.53，p值0.04）。促甲状腺激素（TSH）水平高与TIRADS 2类结节显著相关（95%置信区间0.52 - 1.11，p值<0.0001），尽管三碘甲状腺原氨酸（T3）和甲状腺素（T4）水平正常，但TSH水平低与TIRADS 4类结节相关（95%置信区间 - 1.10 - 0.9，p值<0.0001）。尽管T3和T4水平正常，但TSH水平低以及细胞学检查结果与贝塞斯达2类结节相关，贝塞斯达2类结节是良性滤泡性肿瘤（95%置信区间1.08 - 1.44，p值<0.0001）。大多数有甲状腺结节的患者甲状腺功能测试正常；然而，低TSH水平与FNA显示的TIRAD 4类结节和贝塞斯达2类结节的超声证据显著相关，高TSH水平与TIRADS 2类结节的超声证据显著相关。
