Browse > Article
http://dx.doi.org/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, Shin Hye (Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine)
Kim, Eun-Kyung (Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine)
Moon, Hee Jung (Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine)
Yoon, Jung Hyun (Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine)
Kwak, Jin Young (Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine)
Publication Information
Korean Journal of Radiology / v.17, no.2, 2016 , pp. 255-263 More about this Journal
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.
Keywords
Thyroid cancer; First-degree family history; Ultrasonography; Risk factor;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Malchoff CD, Malchoff DM. Familial nonmedullary thyroid carcinoma. Cancer Control 2006;13:106-110   DOI
2 Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 2010;127:2893-2917   DOI
3 American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2009;19:1167-1214   DOI
4 Gharib H, Papini E, Valcavi R, Baskin HJ, Crescenzi A, Dottorini ME, et al. American Association of Clinical Endocrinologists and Associazione Medici Endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocr Pract 2006;12:63-102
5 Park YJ, Ahn HY, Choi HS, Kim KW, Park do J, Cho BY. The long-term outcomes of the second generation of familial nonmedullary thyroid carcinoma are more aggressive than sporadic cases. Thyroid 2012;22:356-362   DOI
6 Hillenbrand A, Varhaug JE, Brauckhoff M, Pandev R, Haufe S, Dotzenrath C, et al. Familial nonmedullary thyroid carcinomaclinical relevance and prognosis. A European multicenter study. ESES Vienna presentation. Langenbecks Arch Surg 2010;395:851-858   DOI
7 Hemminki K, Eng C, Chen B. Familial risks for nonmedullary thyroid cancer. J Clin Endocrinol Metab 2005;90:5747-5753   DOI
8 Mazeh H, Benavidez J, Poehls JL, Youngwirth L, Chen H, Sippel RS. In patients with thyroid cancer of follicular cell origin, a family history of nonmedullary thyroid cancer in one first-degree relative is associated with more aggressive disease. Thyroid 2012;22:3-8   DOI
9 Alsanea O, Clark OH. Familial thyroid cancer. Curr Opin Oncol 2001;13:44-51   DOI
10 Vriens MR, Suh I, Moses W, Kebebew E. Clinical features and genetic predisposition to hereditary nonmedullary thyroid cancer. Thyroid 2009;19:1343-1349   DOI
11 Alsanea O, Wada N, Ain K, Wong M, Taylor K, Ituarte PH, et al. Is familial non-medullary thyroid carcinoma more aggressive than sporadic thyroid cancer? A multicenter series. Surgery 2000;128:1043-1050; discussion 1050-1051   DOI
12 Sippel RS, Caron NR, Clark OH. An evidence-based approach to familial nonmedullary thyroid cancer: screening, clinical management, and follow-up. World J Surg 2007;31:924-933   DOI
13 Mazeh H, Sippel RS. Familial nonmedullary thyroid carcinoma. Thyroid 2013;23:1049-1056   DOI
14 Vriens MR, Sabanci U, Epstein HD, Ngai S, Duh QY, Siperstein AE, et al. Reliability of fine-needle aspiration in patients with familial nonmedullary thyroid cancer. Thyroid 1999;9:1011-1016   DOI
15 McDonald TJ, Driedger AA, Garcia BM, Van Uum SH, Rachinsky I, Chevendra V, et al. Familial papillary thyroid carcinoma: a retrospective analysis. J Oncol 2011;2011:948786
16 Capezzone M, Marchisotta S, Cantara S, Busonero G, Brilli L, Pazaitou-Panayiotou K, et al. Familial non-medullary thyroid carcinoma displays the features of clinical anticipation suggestive of a distinct biological entity. Endocr Relat Cancer 2008;15:1075-1081   DOI
17 Kim EK, Park CS, Chung WY, Oh KK, Kim DI, Lee JT, et al. New sonographic criteria for recommending fine-needle aspiration biopsy of nonpalpable solid nodules of the thyroid. AJR Am J Roentgenol 2002;178:687-691   DOI
18 McCall A, Jarosz H, Lawrence AM, Paloyan E. The incidence of thyroid carcinoma in solitary cold nodules and in multinodular goiters. Surgery 1986;100:1128-1132
19 Charkes ND. On the prevalence of familial nonmedullary thyroid cancer. Thyroid 1998;8:857-858   DOI
20 Triponez F, Wong M, Sturgeon C, Caron N, Ginzinger DG, Segal MR, et al. Does familial non-medullary thyroid cancer adversely affect survival? World J Surg 2006;30:787-793   DOI
21 Frates MC, Benson CB, Charboneau JW, Cibas ES, Clark OH, Coleman BG, et al. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Radiology 2005;237:794-800   DOI
22 Choi JS, Nam CM, Kim EK, Moon HJ, Han KH, Kwak JY. Evaluation of serum thyroid-stimulating hormone as indicator for fine-needle aspiration in patients with thyroid nodules. Head Neck 2015;37:498-504   DOI
23 Schneider AB, Sarne DH. Long-term risks for thyroid cancer and other neoplasms after exposure to radiation. Nat Clin Pract Endocrinol Metab 2005;1:82-91   DOI
24 Dal Maso L, Bosetti C, La Vecchia C, Franceschi S. Risk factors for thyroid cancer: an epidemiological review focused on nutritional factors. Cancer Causes Control 2009;20:75-86   DOI
25 Moore FD Jr. Inherited aspects of papillary thyroid carcinoma. J Surg Oncol 2006;94:719-724   DOI
26 Khan A, Smellie J, Nutting C, Harrington K, Newbold K. Familial nonmedullary thyroid cancer: a review of the genetics. Thyroid 2010;20:795-801   DOI
27 Papini E, Guglielmi R, Bianchini A, Crescenzi A, Taccogna S, Nardi F, et al. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab 2002;87:1941-1946   DOI
28 Barroeta JE, Wang H, Shiina N, Gupta PK, Livolsi VA, Baloch ZW. Is fine-needle aspiration (FNA) of multiple thyroid nodules justified? Endocr Pathol 2006;17:61-65   DOI
29 Kumar H, Daykin J, Holder R, Watkinson JC, Sheppard MC, Franklyn JA. Gender, clinical findings, and serum thyrotropin measurements in the prediction of thyroid neoplasia in 1005 patients presenting with thyroid enlargement and investigated by fine-needle aspiration cytology. Thyroid 1999;9:1105-1109   DOI
30 Moon WJ, Jung SL, Lee JH, Na DG, Baek JH, Lee YH, et al. Benign and malignant thyroid nodules: US differentiation--multicenter retrospective study. Radiology 2008;247:762-770   DOI
31 Belfiore A, La Rosa GL, La Porta GA, Giuffrida D, Milazzo G, Lupo L, et al. Cancer risk in patients with cold thyroid nodules: relevance of iodine intake, sex, age, and multinodularity. Am J Med 1992;93:363-369   DOI
32 Amir A, Sands N, Hier M, Payne R. Gender as a risk factor of malignancy in a thyroid nodule. Otolaryngol Head Neck Surg 2010;143 suppl:P61
33 Iribarren C, Haselkorn T, Tekawa IS, Friedman GD. Cohort study of thyroid cancer in a San Francisco Bay area population. Int J Cancer 2001;93:745-750   DOI
34 Rago T, Fiore E, Scutari M, Santini F, Di Coscio G, Romani R, et al. Male sex, single nodularity, and young age are associated with the risk of finding a papillary thyroid cancer on fineneedle aspiration cytology in a large series of patients with nodular thyroid disease. Eur J Endocrinol 2010;162:763-770   DOI
35 Tuttle RM, Lemar H, Burch HB. Clinical features associated with an increased risk of thyroid malignancy in patients with follicular neoplasia by fine-needle aspiration. Thyroid 1998;8:377-383   DOI
36 Franklyn JA, Daykin J, Young J, Oates GD, Sheppard MC. Fine needle aspiration cytology in diffuse or multinodular goitre compared with solitary thyroid nodules. BMJ 1993;307:240   DOI
37 Mazzaferri EL, Jhiang SM. Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med 1994;97:418-428   DOI
38 Jonklaas J, Nogueras-Gonzalez G, Munsell M, Litofsky D, Ain KB, Bigos ST, et al. The impact of age and gender on papillary thyroid cancer survival. J Clin Endocrinol Metab 2012;97:E878-E887   DOI
39 Frates MC, Benson CB, Doubilet PM, Kunreuther E, Contreras M, Cibas ES, et al. Prevalence and distribution of carcinoma in patients with solitary and multiple thyroid nodules on sonography. J Clin Endocrinol Metab 2006;91:3411-3417   DOI
40 Bouhabel S, Payne RJ, Mlynarek A, Hier M, Caglar D, Tamilia M. Are solitary thyroid nodules more likely to be malignant? J Otolaryngol Head Neck Surg 2012;41:119-123