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High serum antithyroid antibody values in patients with thyroid nodules are associated with biopsies suspicious for thyroid carcinoma
The background of the study. Patients with thyroid
carcinoma often have high serum antithyroid antibody concentrations,
but whether a high concentration increases the likelihood that a
thyroid nodule is a carcinoma is not known. In this study, the relationships
between serum antithyroid antibody concentrations and the results
of biopsy of thyroid nodules and histology of the nodules that were
excised were studied.
How the study was done. During a two-year interval, consecutive patients with a thyroid nodule underwent fine-needle aspiration biopsy and had measurements of serum antithyroid antibodies. The biopsies were done with ultrasound guidance, and the results were divided into three groups: benign/inadequate, suspicious for follicular tumor, and suspicious for carcinoma.
The results of the study. Among the 590 patients, 197 (33 percent) had a high serum concentration of antithyroid antibodies and 393 (67 percent) did not. As compared with the patients with normal serum antithyroid antibody values, more patients with high serum antithyroid antibody values had biopsies that revealed a follicular tumor (29 vs. 21 percent) or were suspicious for carcinoma (19 vs. 9 percent). Among the patients in whom the biopsy was suspicious for carcinoma, the odds ratio for a high serum antithyroid antibody value was 2.3 (P<0.01).
At surgery, done so far in 106 patients, the nodule was a carcinoma in none of 14 patients from the benign/inadequate-biopsy group, 6 of 31 patients (19 percent) from the follicular-tumor group, and 54 of 61 patients (88 percent) in the suspicious-for-carcinoma group. Among these surgically treated patients, the nodule was a carcinoma in 27 of the 42 (64 percent) with high serum antithyroid antibody values and 33 of the 64 (52 percent) with normal serum antithyroid antibody values (difference not statistically significant).
The conclusions of the study. In patients who have a thyroid nodule, biopsy is more likely to indicate the presence of a follicular tumor or be suspicious for carcinoma in those with high serum antithyroid antibody concentrations than in those with normal concentrations.
The original article. Boi F, Lai ML, Marziani B, Minerba L, Faa G, Mariotti S. High prevalence of suspicious cytology in thyroid nodules associated with positive thyroid antibodies. Eur J Endocrinol 2005;153:637-42.
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Benign thyroid nodules and carcinomas may be distinguished by
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| Thyroid Digest Index | | | March 2006 Thyroid Digest |
