Evaluation of clinical, biohumoral, and morphological findings of the thyroid gland as possible predictors of risk for cancer in patients with atoxic nodular and multinodular goiter

Dragana Malović; Tamara Dragović; Saša Kiković; Petar Ristić; Dejan D. Marinković; Zorana Djuran; Snežana Kuzmić-Janković; Stevan Jovanović; Jelena Rakočević; Zoran Hajduković

doi:10.2298/VSP231201019M

Dragana Malović *Military Medical Academy, Clinic for Endocrinology, Belgrade, Serbia
Tamara Dragović *Military Medical Academy, Clinic for Endocrinology, Belgrade, Serbia; †University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
Saša Kiković Military Medical Academy, Clinic for Endocrinology, Belgrade, Serbia
Petar Ristić *Military Medical Academy, Clinic for Endocrinology, Belgrade, Serbia; †University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
Dejan D. Marinković *Military Medical Academy, Clinic for Endocrinology, Belgrade, Serbia; †University of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade, Serbia
Zorana Djuran Military Medical Academy, Clinic for Endocrinology, Belgrade, Serbia
Snežana Kuzmić-Janković Military Medical Academy, Clinic for Endocrinology, Belgrade, Serbia
Stevan Jovanović Military Medical Academy, Clinic for Endocrinology, Belgrade, Serbia
Jelena Rakočević University of Belgrade, Faculty of Medicine, Institute of Histology and Embryology, Belgrade, Serbia
Zoran Hajduković Military Medical Academy, Clinic for Endocrinology, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP231201019M

Keywords: biopsy, fine needle;, goiter;, neoplasm staging;, thyroid neoplasms;, thyroid nodule.

Abstract

Background/Aim. Thyroid nodules are usually asymptomatic and may occur in 68% of the general population. In most cases, they are discovered incidentally. As malignancy is proven in 10–15% of cases, a rational diagnostic approach is necessary. The aim of this retrospective study was to examine and grade different characteristics of patients with nodular and multinodular atoxic goiter in order to identify the potential predictors for the assessment of thyroid cancer risk. Methods. The study included 275 patients with nodular and multinodular atoxic goiter hospitalized at the Clinic for Endocrinology of the Military Medical Academy, Belgrade, Serbia, from January 1, 2017, to October 1, 2022, for preoperative preparation. The most relevant clinical, biohumoral, and pathomorphological characteristics were analyzed. Results. Patients with multiple thyroid nodules were older (57.21 ± 13.16 vs. 49.36 ± 15.83 years, p < 0.001) and had higher body mass index (29.12 kg/m² vs. 26.50 kg/m², p = 0.004) compared to patients with one nodule. On the other hand, patients with one thyroid nodule had a higher level of the thyroid-stimulating hormone than patients with multiple nodules (1.73 mIU/L vs. 1.21 mIU/L, p < 0.0001). Comparison of patients with and without proven thyroid cancer has shown a highly significant association between the higher categories of Bethesda classification and the presence of cancer (Bethesda IV–VI vs. Bethesda II–III, 52.2% vs. 22.3%, respectively, p = 0.002). Conclusion. Considering all the observed parameters, the cytological finding of fine needle aspiration biopsy emerged as the only one with predictive relevance for assessing thyroid cancer risk.

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