%0 Journal Article
%T Risk Factors Associated with Benign and Malignant Thyroid Nodules in Autoimmune Thyroid Diseases
%A Priscila Carneiro Moreira Lima
%A Arnaldo Moura Neto
%A Marcos Antonio Tambascia
%A Denise Engelbrecht Zantut Wittmann
%J ISRN Endocrinology
%D 2013
%R 10.1155/2013/673146
%X Objectives. Assess the prevalence of thyroid nodules and predictors of malignant origin in patients with autoimmune thyroid diseases. Patients and Methods. Retrospective study including 275 patients, 198 with Graves' disease and 77 with Hashimoto＊s thyroiditis. Clinical and demographical data, ultrasonographical nodule characteristics, total thyroid volume and histological characteristics were recorded. Results. Graves＊ disease: the prevalence of thyroid nodules and thyroid carcinoma were 27.78% and 5.05%, respectively. Older age (OR = 1.054; 95% CI = 1.029每1.080) and larger thyroid volumes (OR = 1.013; 95% CI = 1.003每1.022) increased the chance of nodules. Younger age (OR = 1.073; 95% CI = 1.020每1.128) and larger thyroid volume (OR = 1.018; 95% CI = 1.005每1.030) predicted thyroid carcinoma. Hashimoto＊s thyroiditis: the prevalence of thyroid nodules and carcinomas were 50.7% and 7.8%, respectively. Nodules were predicted by thyroid volume (OR = 1.030; 95% CI = 1.001每1.062). We found higher number of nodules in patients with thyroid carcinoma than in those with benign nodules (3 versus 2; ). Patients with Hashimoto＊s thyroiditis presented nodules more frequently than patients with Graves＊ disease (50.65% versus 27.28%; ), while the prevalence of carcinoma was similar ( ). Conclusions. Larger goiter was associated with carcinoma in Graves＊ disease and Hashimoto＊s thyroiditis. Younger patients presented higher risk of papillary thyroid carcinoma in Graves＊ disease. The prevalence of carcinoma was similar in both conditions. 1. Introduction Association between thyroid autoimmunity and nodules or carcinoma has been suggested in many previous works, but its clinical significance is still uncertain [1]. Whether all patients with autoimmune thyroid diseases are at increased risk for nodules and thyroid cancer or if there are certain individual characteristics that augment this risk is still debatable. In patients with Graves＊ disease (GD), nodules are detected in 10每31% of cases [2], and approximately half will present nodules during followup [3]. Some studies have shown that around 17% of those nodules are malignant, whereas in the healthy population this estimate is 5% [4]. It is also known that 1.7每2.5% of patients with GD present malignant nodules, compared to 0.25% in the general population [5], evidencing a greater risk for thyroid carcinoma in this condition. There is a strong link between thyroid carcinoma and GD, which can be considered an adverse prognostic factor [6]. Hashimoto＊s thyroiditis (HT) is frequently associated with small thyroid nodules,
%U http://www.hindawi.com/journals/isrn.endocrinology/2013/673146/