Korean J Radiol.  2016 Apr;17(2):255-263. 10.3348/kjr.2016.17.2.255.

Risk of Thyroid Cancer in Euthyroid Asymptomatic Patients with Thyroid Nodules with an Emphasis on Family History of Thyroid Cancer

• Hwang SH
• Kim EK
• Moon HJ
• Yoon JH
• Kwak JY

• KMID: 2360211
• DOI: http://doi.org/10.3348/kjr.2016.17.2.255

Abstract

OBJECTIVE
To determine the factors associated with thyroid cancer, focusing on first-degree family history and ultrasonography (US) features, in euthyroid asymptomatic patients with thyroid nodules.
MATERIALS AND METHODS
This retrospective study included 1310 thyroid nodules of 1254 euthyroid asymptomatic patients who underwent US-guided fine-needle aspiration biopsy between November 2012 and August 2013. Nodule size and clinical risk factors-such as patient age, gender, first-degree family history of thyroid cancer, multiplicity on US and serum thyroid stimulating hormone (TSH) levels-were considered together with US features to compare benign and malignant nodules. Multiple logistic regression analysis was performed to assess the risk of thyroid malignancy according to clinical and US characteristics.
RESULTS
Although all of the clinical factors and US findings were significantly different between patients with benign and malignant nodules, a solitary lesion on US (p = 0.041-0.043), US features and male gender (p < 0.001) were significant independent risk factors for thyroid malignancy in a multivariate analysis. Patient age, a first-degree family history of thyroid cancer and high normal serum TSH levels did not independently significantly increase the risk of thyroid cancer. However, multicollinearity existed between US assessment and patient age, first-degree family history of thyroid cancer and serum TSH values.
CONCLUSION
Ultrasonography findings should be the primary criterion used to decide the management of euthyroid asymptomatic patients with thyroid nodules. The concept of first-degree family history as a risk factor for thyroid malignancy should be further studied in asymptomatic patients.

Keyword

Thyroid cancer; First-degree family history; Ultrasonography; Risk factor

MeSH Terms

Adult
Aged
Biopsy, Fine-Needle
Family
Female
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Retrospective Studies
Risk Factors
Sex Factors
Thyroid Neoplasms/pathology/*ultrasonography
Thyroid Nodule/pathology/*ultrasonography
Thyrotropin/blood
Thyrotropin

Figure

• 

  Fig. 1 Flow chart of case enrollment. FNA = fine-needle aspiration

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