Prevalence and Risk Factors Related to Malignancy of Bethesda Category III Thyroid Nodules Phatthalung Hospital
Keywords:The Bethesda system, Thyroid nodule, Thyroid malignancy
This retrospective cohort study evaluates the prevalence of malignancy and risk factors related to thyroid malignancy in patients who have thyroid mass. The study subjects were patients who underwent FNA and were diagnosed as Bethesda category III in Phatthalung hospital between November 1, 2016 and December 30, 2020. Data were analyzed using univariate analysis and multiple logistic regression. A total of sixty eight patients were identified as Bethesda category III, of which 39.71 % went on to immediate thyroid lobectomy (39.71%). Pathological finding showed malignancy rate of 48.15 % with the most common thyroid cancer being papillary thyroid carcinoma 92.3 % followed by follicular carcinoma 7.69 %. Risk factors associated with thyroid carcinoma was patient age < 40 years (OR=11.50, 95%CI=1.10-120.60, P=0.042). While site and size of thyroid nodule were risk factor but statistically not significant. The prevalence of thyroid malignancy in study was 48.15 %. Therefore in patient younger than 40 years with thyroid mass requires early diagnosis and appropriate treatment can improve prognosis and reduce mortality.
Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE. Pacini F, Randolph GW, Sawka AM, Schlumberger M, Schuff AG, Sherman SI, Sosa JA, Stewars DL, Tuttle M, Wartofsky L. 2015 American thyroid association Management guidelines for adult patients with thyroid nudules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid cancer. Thyroid 2016; 26(1): 1-133.
Settakorn J, Chaiwan B, Thamprasert K, Wisedmongkol W, Rangdaeng S. Fine needle aspiration of thyroid gland. J Med Assoc Thai 2001; 84(10): 1401-1406. (In Thai)
Chouykaw P, Ratanaanekchai T, Thanaviratananich S, Kanjanavirojkul N, The predictive values of fine needle aspiration in thyroid nodule(s) at Srinakarind Hospital. Thai J Otolaryngol Head Neck Surg 2009; 10(3): 37-44. (In Thai)
Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedus L, Vitti P. American association of clinical endocrinologists, associazione medici endocrinologi, and European thyroid association Medical guidelines for clinical practice for the diagnosis and management of thyroid nodules: executive summary of recommendations. Endocr Pract 2010; 16(3): 468-475.
Nguansangiam S. Usefulness of the Bethesda system for reporting thyroid fine-needle aspiration specimens. Vajira Medical Journal 2013; 57(1): 2764. (In Thai)
Wu HH, Swadley MJ. The Bethesda system for reporting thyroid cytopathology: into the clinic. Pathology and laboratory medicine international 2015; 7: 47-54.
Crippa S, Mazzucchelli L, Cibas ES, Ali SZ. The Bethesda system for reporting thyroid fine-needle aspiration specimen. Am J Clin Pathol 2010; 134(2): 343-4.
Anand B, Ramdas A, Ambroise MM, Kumar NP. The Bethesda system for reporting thyroid cytopathology: A cytohistological study. Journal of thyroid research 2020; 1-8.
Ho AS, Sarti EE, Jain KS, Wang H, Nixon IJ, Shaha AR, Shah JP, Kraus DH, Ghossein R, Fish SA, Wong RJ, Lin O, Morris LGT. Malignancy rate in thyroid nodules classified as Bethesda category III (AUS/FLUS). Thyroid 2014; 24(5): 832-839.
Nakrangsee S. Cytopathology reporting using the new Bethesda system of thyroid FNAC and correlation with histopathological follow-up : A three-year study of routine service at Rajavithi hospital. J Med Assoc Thai; 2018; 101(Suppl.2): S122-S132. (In Thai)
Haisiri P. Achievement on histopathology technique for correct diagnosis cancer of the thyroid gland both single H&E staining technique and when combined with immunohistochemistry (IHC) technique of Phrapokklao hospital in fiscal year 2013. J Prapokklao Hosp Clin Med Educat Center 2014; 31(3): 194-204. (In Thai)
Cibas ES. Aliz SZ. The Bethesda system for reporting thyroid cytopathology. Am J Clin Patho 2009; 19(11): 1159-1165.
Benjakul N, Sripodok S, Tungjitsirisum T, Pattaravoratham P, Soiphet T. Accuracy of fine needle aspiration pathology of thyroid lesions: An 8-years experience in urban-based tertiary medical center in Bangkok, Thailand 2021; 65(6): 502-512. (In Thai)
Cibas ES, Ali SZ. The Bethesda system for reporting thyroid cytopathology. Thyroid 2017; 27(11): 1341-1346.
Rano E, Lin L, Molinie V, Sulpicy C, Dorival M-J, Alsibai KD, Nacher M, Drame M, Sabbah N. Epidemiological, clinical, ultrasonographic and cytological characteristic of thyroid nodules in an Afro-caribbean population:a series of 240 patiens. Cancer 2020; 14: 2365-2379.
Nguyen QT, Lee EJ, Huang MG, Park YI, Khullar A., Plodkowski R.A. Diagnosis and treatment of patients with thyroid cancer. American Heath & Drug Benefit 2015; 8(1):30-40.
Wongwattana P, Siangsung T, Bhuripongrat N, Pakornlersiri R, Sataponpongpinyo P, Chiencharoenthanakit R, Pongprasobchai A. Diagnostic accuracy of fine needle aspiration in thyroid mass in HRH Prince Maha Chakri Sirindhorn medical center. J Med Health Sci 2020; 27(3): 112-122. (In Thai)
Chaisawat S. Diagnostic performance of fine needle aspirate biopsy (FNAB) among thyroid gland neoplasm in Mae Sod general hospital 2015; 6(2): 2-8. (In Thai)
Sungkanakara C. Diagnostic accuracy of fine needle aspiration biopsy for detection of malignancy in thyroid nudules in Somdet Phra Phuttha Loetla hospital. RTA Med J 2019; 72(1): 39-49. (In Thai)
White MC, Holman DM, Boehm JE, Peipins LA, Grossman M, Henley SJ. Age and cancer risk: A Potentially Modifiable Relationship. American Journal of Preventive Medicine 2014; 46(3), 7–15.
Dumrisilp S. Incidence and Analysis of factors related to Thyroid Cancer in Patients Undergoing Surgery at the Otolaryngology Department at Krathum Baen Hospital. Hua Hin Medical Journal 2022; 2(1): 22-33. (In Thai)
Kaewjumpot K. Predictive value of fine needle aspiration of thyroid nodules in Angthong hospital. Chiangrai medical journal 2021; 13:28-46. (In Thai)
Sun W, Lan X, Zhang H, Dong W, Wang Z, He L, Zhang T, Liu S. Risk factors for central lymph node metastasis in CNP papillary thyroid carcinoma: Asystematic review and meta analysis. PLOS ONE 2015; 10(10): e0139021.
Somcharoenwattana P. Pathologic lymph node results and the risk factors of malignancy in the patients who presented with cervicallymphadenopathy at Otolaryngology department, Phatthalung hospital. Reg 11 Med J 2018; 32(4): 1407-1418. (In Thai)
Dumrisilp S. Incidence and analysis of factor related to thyroid cancer in patients undergoing surgery at the Otolaryngology department at Kratum Baen hospital. Hua Hin medical journal 2022; 2(1): 22-33. (In Thai)
How to Cite
Copyright (c) 2022 Health Science Journal of Thailand
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.