Online ISSN: 2515-8260

Keywords : Thyroid nodules


A Study to Correlate Preoperative Ultrasonographic Tirads Scoring System and Postoperative Histopathology of Thyroid Swellings

J.Parthasarathi, D.Ravisundar, M.Praveena, M. Anurag

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2451-2460

Background:Aim & Objectives: To correlate preoperative TIRADS scoring system with postoperative histopathology of thyroid swellings.
Materials and Methods: A total of 66 patients of thyroid swellings who were treated at the Department of General Surgery, Govt Medical College, Nalgonda, with an age range of 20 – 68 years, were evaluated in this study with respect to age, sex, symptoms type and symptom duration and were investigated with routine hemogram, thyroid profile, FNAC and USG with TIRADS score. The results of USG TIRADS score were compared with the histopathology after excision of the thyroid swelling.
Results: Thyroid swellings are more common in females than in males (M:F ratio = 1:4). Majority of the patients are in the age group of 30-50 years. Swelling in front of the neck is the most common complaint. Majority of the patients had an average duration of symptoms of 6months to 3 years. On clinical evaluation all patients had swelling of thyroid. On USG with TIRADS scoring, TIRADS – 3 is the most common category of the thyroid swelling with 30 patients (45%). On USG TIRADS score, majority were benign lesions 55 (83%), while the rest were malignant 11 (17%). On histopathology, 55 lesions (83%) were benign, while 11 lesions (17%) were malignant. Incidence of malignancy with respect to TIRADS score is TIRADS 2- 4%, TIRADS 3 – 16.7%, TIRADS 4 – 50%, TIRADS 5 – 0%. The present study has a USG TIRADS score sensitivity of 45.5%, specificity of 89.1%, positive predictive value of 45.5%, negative predictive value of 89.1% and accuracy of 81.8%.  The prevalence of malignancy among the patients with thyroid swellings in the present study is 16.7%. USG proved to be a more sensitive modality to evaluate the nodularity of thyroid swellings than clinical evaluation.
Conclusion: The present study was undertaken to evaluate the usefulness of clinical evaluation and USG TIRADS score in management of thyroid nodules High resolution ultrasound is an accurate technique, that has helped to analyse the suspicious sonographic features of thyroid swellings and to assess the risk of malignancy and quantify it using TIRADS score.

SERUM MICRORNA-222 EXPRESSION for MALIGNANCY PREDICTION in SAMPLE of EGYPTIAN EUTHYROID PATIENTS with INDETERMINATE THYROID NODULE

Sherihan AboElyazed Mohamed; Mohamed Reda Halawa; Yara Mohamed Eid; Maram Mohamed Maher; Lamyaa Salem; Salah Hussein Elhalawany

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 325-334

Background: The Prevalence of thyroid nodules is rising nowadays, luckily most of
them are benign. The risk of malignancy 5-15%, which necessitates the ultimate need to
accurately distinguish benign from malignant nodule to avoid unnecessary
thyroidectomy with risk of recurrent laryngeal nerve injury, postoperative
hypothyroidism and lifetime thyroid replacement therapy, and other complications
related to surgery and anaesthesia. Recent evidence suggests that circulating miRNA
might have probable advantage as diagnostic or prognostic markers for numerous
cancers. Given their reproducible and constant presence in sera, miRNA profiles have
emerged as a non-invasive method to categorise a wide variety of human cancers. This
study aimed to evaluate a possible relationship between the expression level of
circulating miRNA-222 and the histological outcome of euthyroid patients undergoing
thyroidectomy for thyroid nodules with indeterminate FNAC. This study included 45
euthyroid patients with inderteminate thyroid nodules diagnosed with ultrasound and
FNAC which planed for thyroidectomy. Quantitative assay of serum micro RNA-222
expression by quantitative Real-Time polymerase chain reaction (qRT-PCR) performed
preoperatively, and results compared with postoperative histopathology.
Results: The incidence of thyroid nodules was predominant in female gender in benign
group and malignant group. Risk of malignancy increases as TI-RADS and Bethesda
scores increases. Also, larger nodule in size has a more risk of malignancy (p= 0.027).
Expression level of circulating miRNA-222 in serum can’t differentiate between benign
and malignant patients where there was no significant difference between them
statistically (p=0.905). Circulating miRNA-222 was a poor predicator for malignant
nodules with sensitivity of 50%, specificity of 32.43%, with high negative predictive
value (NPV=75%).
Conclusion: Although circulating miRNA-222 has been identified as novel minimally
invasive biomarker for preoperative prediction of malignant nodules, but in our study,
it did not show a value as a tool for discrimination of malignant nodules. Ultrasound
remained important procedure in preoperative prediction and management of thyroid
nodules especially when correlating to nodule size which had positive correlation with
malignancy in our study.

Study Of Serum Micro-Rna 221 Expression In Patients With Thyroid Nodules And Its Relation To Outcome

Sherief Samy Bayomy Mohamed; Prof. Dr. Raef Malak Botros; Prof. Dr. Emad El Din Farid Ibrahim; Dr. Alyaa Ahmed ElSherbini; Dr. Lamyaa Salem; Dr. Hanan Mahmoud Ali

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 9, Pages 577-587

Background: Thyroid nodules are extremely common and are usually benign. 4%-6.5% from thyroid nodulesaremalignant. Among Thyroid cancer investigations manydiagnostic molecular biomarkers were found to have applications in thyroid nodules managment and avoid unnecessary thyroidectomy.(1)
This study aims:To detect value of micro-RNA 221 expression in sera of Patients with thyroid nodules and its relation to outcome after surgery.
Patients and Methods: Forty-five adult subjects aged between 18 to 70-years old who were diagnosed with suspicious thyroid nodules that required total thyroidectomy were offered participation in the study. In addition, five healthy Subjects, were included as a control group, based on the patient’s history, physical examination, US and FNAB findings. Patients who had thyroid nodules with U/S pattern suggestive of malignant potential (TIRADS score ≥ 3),also with indeterminate FNAB results (Bethesda III, IV)were selected. Samples of human plasma were collected from selected patients visiting outpatient clinics. Results was correlated with postoperative pathology results.
Results: In our study there was no significant difference regarding outcome in patients (benign or malignant) with respect to serum microRna 221. There was a significant difference between benign and malignant outcomes regarding size of dominant nodules by ultrasound with a mean value equals 4.6 cm in largest dimension in patients with malignant thyroid nodules and p value equals 0.027 indicating increased size of nodule may be associated with increased risk of malignancy.