Background: The discovery of a thyroid nodule is a problem in thyroid cancer screening. Thus, the analysis of the criteria of malignancy remains the first step of study of a thyroid nodule. The objective of our study was the correlation between the clinical, ultrasonographic and cytologic malignancy criteria and the anatomopathological study results of the operative specimen.
Materials and methods: For this we conducted an analytical cross-sectional study including 198 patients presenting a nodule or a nodular goiter admitted during the year 20122018 to the endocrinology department of Ibn Rochd University Hospital of Casablanca and having benefited from a fine needle aspiration biopsy of thyroid nodules then a surgery.
Results: This series accounted for 55.5% of cancers. The median age of our patients was 41 years (1875) with a clear female predominance. The study showed a significant statistical relationship between hard consistency, clinical presence of cervical lymphadenopathy and signs of locoregional compression with nodular malignancy (P<0.001). On ultrasound, the malignant nodules had an average size of 3.45 cm (1.57 cm), they had in 45% of cases a hypoechoic appearance, blurred outlines in 30% of cases, one of the microcalcifications in 47% of them. The TIRADS score had a sensitivity, specificity, a positive predictive value and a negative predictive value of 88.6%, 58%, 39.6% and 94.3% respectively. The sensitivity of the needle aspiration was 94% and the specificity was 70%, with a positive predictive value of 72.5% and a negative predictive value of 94%.
Conclusion: According to our study, the evidence for malignancy was advanced age (>50 years), hard nodule consistency, dyspnea, presence of reccurential paralysis, poorly limited ultrasound, microcalcifications and the presence of lymphadenopathies on clinical examination and ultrasonography and suspicious cytology. The association of clinical and ultrasound criteria for suspicion of malignancy nodular, with cytological findings can improve the screening sensitivity of nodular carcinomas, so a better selection of patients to operate.
18 - 21 May 2019
European Society of Endocrinology