DOI QR코드

DOI QR Code

Risk Factors Associated with Thyroid Carcinoma in North Pakistan

  • Khan, Muhammad Aleem (Nuclear Medicine Department, Nuclear Medicine, Oncology and Radiotherapy Institute) ;
  • Khan, Kamran Hakeem (Department of General Surgery, Pakistan Institute of Medical Sciences) ;
  • Shah, Sajid Ali (Department of General Surgery, Pakistan Institute of Medical Sciences) ;
  • Mir, Kahkashan Ali (Nuclear Medicine Department, Nuclear Medicine, Oncology and Radiotherapy Institute) ;
  • Khattak, Mubarik (Department of General Surgery, Pakistan Institute of Medical Sciences) ;
  • Shahzad, Muhammad Faheem (Nuclear Medicine Department, Nuclear Medicine, Oncology and Radiotherapy Institute)
  • Published : 2016.02.05

Abstract

Background: Epidemiological data on thyroid cancer and associated risk factors are scarce in our setting. The present study was therefore designed to gather data which could be helpful in providing insights to thyroid physicians and surgeons for better management of affected patients. Purpose: To determine the frequency of carcinoma thyroid among patients presenting with goiter and its association with TSH, Tg/ATg and other demographic factors. Materials and Methods: A total of 73 adult patients of either gender with solitary solid cold nodules and/or multi-ndoular goiter (MNG) with predominant solid cold nodules were enrolled. All surgically resected samples were sent for histopathology. The frequency of thyroid cancer and its subtypes was noted and tested for association with gender, age (< or ${\geq}40years$), recent increase in swelling size, TSH, Tg and ATg. Results: Thyroid cancer was diagnosed in 26% (n=19) of the patients, 14 (73.7%) being diagnosed with papillary thyroid cancer and 5 (26.3%) with follicular thyroid cancer. No other subtypes were noted. Presence of thyroid cancer was significantly associated with recent increase in swelling size and higher TSH Values mean TSH values (P<0.05). No significant association was found with gender, age, Tg and ATg values (P>0.05). Conclusions: Overall percentage of thyroid cancer in our study sample was found to be 26%, with a predominance of papillary over follicular lesions. Rates were significantly higher in patients who had history of recent increase in swelling size and higher and higher pre-surgery TSH values.

Keywords

Thyroid cancer;goiter;thyroid nodules;TSH

References

  1. Afolabi AO, Oluwasola AO, Akute OO, Akang EE, Ogundiran TO, Ogunbiyi JO (2010). Review of fine needle aspiration cytology in the management of goitres in Ibadan, Nigeria. Niger J Clin Pract, 13, 163-6.
  2. Albasri A, Sawaf Z, Hussainy AS, Alhujaily A (2014). Histopathological patterns of thyroid disease in Al-Madinah region of Saudi Arabia. Asian Pac J Cancer Prev, 15, 5565-70. https://doi.org/10.7314/APJCP.2014.15.14.5565
  3. Belfiore A, La Rosa GL, La Porta GA (1992). Cancer risk in patients with cold thyroid nodules: relevance of iodine intake, sex, age, and multinodularity. Am J Med, 93, 363-4. https://doi.org/10.1016/0002-9343(92)90164-7
  4. Belfiore A, Giuffrida D, La Rosa GL (1989). High frequency of cancer in cold thyroid nodules occurring at young age. Acta Endocrinol (Copenh), 121, 197-9.
  5. Boelaert K, Horacek J, Holder RL (2006). Serum thyrotropin concentration as a novel predictor of malignancy in thyroid nodules investigated by fine-needle aspiration. J Clin Endocrinol Metab, 91, 4295-7. https://doi.org/10.1210/jc.2006-0527
  6. Bukhari S, Sadiq S, Memon J, Baig F (2009). Thyroid Carcinoma in Pakistan : a retrospective review of 998 cases from an academic referral centre. Hematol Oncol Stem Cell, 2, 345-8. https://doi.org/10.1016/S1658-3876(09)50023-4
  7. Dong W, Zhang H, Li X, Hel Wang Z (2013). The changing incidence of thyroid cancer in Shenyang, China before and after universal salt iodization. Med Sci Monit, 19, 49-53. https://doi.org/10.12659/MSM.883736
  8. Frates MC, Benson CB, Doubilet PM (2006). Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. J Clin Endocrinol Metab, 91, 3411-3. https://doi.org/10.1210/jc.2006-0690
  9. Haymart MR, Repplinger DJ, Leverson GE (2008). Higher serum thyroid stimulating hormone level in thyroid nodule patients is associated with greater risks of differentiated thyroid cancer and advanced tumor stage. J Clin Endocrinol Metab, 93, 809-12. https://doi.org/10.1210/jc.2007-2215
  10. Iftikhar A, Naseeb AK, Khwaja A, et al (2011). Patterns of differentiated thyroid cancer in Balochistan province of Pakistan: Some initial observations. Med J Malaysia, 66, 322-5.
  11. Kamran SC, Marqusee E, Kim MI (2013). Thyroid nodule size and prediction of cancer. J Clin Endocrinol Metab, 98, 564-5. https://doi.org/10.1210/jc.2012-2968
  12. McLeod DS, Cooper DS, Ladenson PW (2014). Prognosis of differentiated thyroid cancer in relation to serum thyrotropin and thyroglobulin antibody status at time of diagnosis. Thyroid, 24, 35-6. https://doi.org/10.1089/thy.2013.0062
  13. Moosa SA, Junaid M, Khan FW, Afzal Y, Sultan N (2007). Prevalence of malignancy in resected specimens of patients operated for benign nodular goiter. Pak J Surg, 23, 29-32.
  14. Morris LG, Sikora AG, Tosteson TD, Davies L (2013). The increasing incidence of thyroid cancer: the influence of access to care. Thyroid, 23, 885-91. https://doi.org/10.1089/thy.2013.0045
  15. Mortensen JD, Woolner LB, Bennett WA (1955). Gross and microscopic findings in clinically normal thyroid glands. J Clin Endocrinol Metab, 15, 1270-2. https://doi.org/10.1210/jcem-15-10-1270
  16. Qureshi IA, Khabaz MN, Baig M, et al (2015). Histopathological findings in goiter: A review of 624 thyroidectomies. Neuro Endocrinol Lett, 36, 48-52.
  17. Schlumberger M, Hitzel A, Toubert ME (2007). Comparison of seven serum thyroglobulin assays in the follow-up of papillary and follicular thyroid cancer patients. J Clin Endocrinol Metab, 92, 2487-91. https://doi.org/10.1210/jc.2006-0723
  18. Sisson JC (1989). Medical treatment of benign and malignant thyroid tumors. Endocrinol Metab Clin North Am, 18, 359-63.
  19. Soomro SA, Memon MR, Abro H, Mahar M (2011). Frequency of malignancy in cold nodule thyroid. Med channel, 17, 44-9.
  20. Weightman DR, Mallick UK, Fenwick JD, Perros P (2003). Discordant serum thyroglobulin results generated by two classes of assay in patients with thyroid carcinoma: correlation with clinical outcome after 3 years of follow-up. Cancer, 98, 41-5. https://doi.org/10.1002/cncr.11472
  21. Werk EE, Vernon BM, Gonzalez JJ (1984). Cancer in thyroid nodules. A community hospital survey. Arch Intern Med, 144, 474-5. https://doi.org/10.1001/archinte.1984.00350150058018

Cited by

  1. WOMEN IN CANCER THEMATIC REVIEW: Thyroid-stimulating hormone in thyroid cancer: does it matter? vol.23, pp.11, 2016, https://doi.org/10.1530/ERC-16-0328