Predictive Importance of Ultrasonography and Anti-Thyroid Antibodies in the Management of Thyroid Nodules in Indeterminate Cytology
Sevki Peduk1, Suat Benek21Department of Surgical Oncology, Mardin Training and Research Hospital, Mardin, Turkey, 2Department of General Surgery, Tekirdag Namık Kemal University, Tekirdağ, Turkey
Objectives: The aim of this study is to examine the effects of ultrasonography and serum anti-thyroid antibody (ATAb) levels in predicting malignancy in cases where molecular tests cannot be performed in indeterminate thyroid nodules. Methods: Ultrasonographic features of the dominant thyroid nodule of a total of 228 patients who were operated for nodular goiter were analyzed and preoperative serum ATAb levels were examined. Especially in Bethesda category 3 nodules correlation of these parameters with malignancy rates and Hashimoto’s thyroiditis (HT) was investigated. Results: Malignancy was detected in 24.5% (12/49) Bethesda Category 3 nodules. Anti-thyroglobulin (Anti-TG) and-or anti-thyroid peroxidase (anti-TPO) positivity in serum 36.5% (72/197) was correlated with histopathologically proven HT (p=0.001). Poor prognostic factors were found to be less common in HT-associated papillary thyroid cancer (PTC). Ultrasonographic characteristics such as hypoechogenicity, microcalcification, and border irregularity were significant in predicting malignancy in indeterminate nodules (p=0.038- 0.003- 0.004, respectively). The central vascularization pattern remained in the background compared to other parameters (p=0.059). In the presence of ultrasonographic halo, 92.7% (51/55) of the nodules were benign (p=0.001). Conclusion: In the management of thyroid nodules in indeterminate cytology, suspicious ultrasonographic features and Hashimoto's thyroiditis should be encouraging in making the surgical decision. Keywords: Bethesda system; anti-thyroid antibody; chronic lymphocytic thyroiditis; thyroid cancer.
Cite This Article
Peduk S, Benek S. Predictive Importance of Ultrasonography and Anti-Thyroid Antibodies in the Management of Thyroid Nodules in Indeterminate Cytology. EJMI. 2022; 6(1): 122-127
Corresponding Author: Sevki Peduk