Analysis of malignancy predictors for follicular thyroid tumors

Background/Aim. Establishing a preoperative diagnosis of thyroid follicular tumors is difficult due to the fact that the cell morphology of adenomas and carcinomas are similar and that capsular and vascular invasion cannot be determined by cytology. We analyzed predictive factors of follicular carcinoma in order to enable a surgeon to indicate operative treatment and to perform an adequate operation for each patient with a follicular neoplasm. Methods. In this retrospective study, we analyzed medical records of all patients with follicular thyroid tumors operated at an endocrine surgery unit of a tertiary referral academic hospital, between 2008 and 2012. A total of 263 operated patients were included and divided into follicular adenomas (n = 97) and follicular carcinomas (n = 166) based on the histopathology results. The most important demographic and clinical characteristics were analyzed by univariate and multivariate logistic regression analysis. Results. In adenoma group (19 males, 78 females) age range was 19?79, mean age 50. In carcinoma group (35 males, 131 females) age range was 15? 78, mean age 48. Univariate analysis showed that thyroglobulin concentration ? 500 ng/mL, tumor diameter < 30 mm, presence of more than one thyroid nodule and an afunctional/hypofunctional nodule were significantly more frequent in follicular carcinoma than in follicular adenoma. Independent predictive factors of malignancy were: elevated preoperative thyroglobulin concentration (? 500 ng/mL) and presence of more than one nodule. Based on our results we formed a nomogram, a two-dimensional diagram designed to enable estimation of preoperative probability of malignancy. Conclusion. Elevated preoperative thyroglobulin concentration, ? 500 ng/mL, and the presence of more than one nodule are independent predictors of malignancy for follicular thyroid carcinomas.

Evaluating of significance of thyroglobulin (Tg) level in blood as a biomarker of iodine deficiency disorders severity in Uzbekistan

Iodine deficiency has serious adverse effects on growth and development of humans, such as mental impairment. It is known, that thyroglobulin level in blood is promising biomarker that can determine iodine deficiency disorders severity in a given region. The Aim of study: Evaluating of significance of thyroglobulin level in blood as a biomarker of iodine deficiency disorders severity in Uzbekistan.. Materials and Methods: We evaluated thyroglobulin level in blood in schoolchildren of Uzbekistan. In this purpose we studied 366 schoolchildren in 8-12 age group, of that 163 boys and 203 girls living in Tashkent city, Fergana, Samarkand, Bukhara, Kashkadarya, Khoresm and Republic of Karakalpakistan. Such parameters as urinary iodine concentration, diffuse goiter plasma TSH, fT4 were analyzed too. Results: Diffuse goiter prevalence was 27 % among children, the overall mean thyroglobulin concentration was 12,8 ± 10.4 ng/ml, the overall median urinary iodine concentration (UIC) was 120.27 μg/L indicating iodine sufficiency. Plasma TSH was 2.75 ± 1.69 mIU/l and plasma fТ4 14.48 ± 3,96 pmol/l. Thyroglobulin level depended on goiter size, so that in children without goiter (grade 0) mean thyroglobulin concentration was 11,9 ± 7.9 ng/ml, in children with goiter grade 1 mean thyroglobulin concentration was 14,24 ± 13.5 ng/ml and in children with goiter grade 2 mean thyroglobulin concentration was 18,82±18,3 ng/ml. Overall mean thyroglobulin concentration of goitrous children (grade 1 and 2) was 16,4±10,5 ng/ml. Conclusions: Though international studies in school-aged children showed that iodine-sufficient children typically had a median Tg <13 ng/ml, our investigation showed that while study group’s UIC was 120.27 μg/L and overall mean thyroglobulin concentration was 12,8 ± 10.4 ng/ml, that is equal to median thyroglobulin concentration – 11,73 ng/ml, 39% of children in this group still have UIC below 100 μg/L.