Changes of Nodular Size and Its Risk Factors in Iodine-Sufficient Area: a Retrospective Cohort Analysis of 7753 Thyroid Nodules
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background and Objectives: Iodine is known to be an important factor in the occurrence of goiter, and SouthKorea is a region with sufficient iodine supplementation. In this regard, we checked the size change of thyroidnodules found by health check-up in Koreans and examined which risk factors influence the size change. Materialsand Methods: A total 7753 subjects who underwent thyroid sonography two or more times were included. Wedefined that there was a change in the size of the nodule when the difference in diameter identified in the lastultrasound was more than 3 mm. Results: Thyroid nodules were decreased in 895 subjects (11.5%) and increasedin 1041 subjects (13.5%). The rate of increased nodule was on an increasing trend according to the duration(annual percent change 2.6%, p＜0.001). In contrast, the rate of decreased nodule was unchanged. Predictivefactors related to decrease of the nodule size were young age, male sex, larger initial nodule size and thyroiditis. Similarly, young age, larger initial nodule size and diffuse parenchymal abnormality were significant predictivefactors for increased nodules. However, diffuse parenchymal abnormality was not a predictive factor when weanalyzed only thyroid nodules larger than 1 cm. Conclusion: In our study, 11.5-13.5% of benign thyroid noduleswere increased or decreased during median 27 months of follow-up in iodine sufficient condition. Young age,larger initial size and diffuse parenchymal abnormality were common predictive factor affecting both the increaseand decrease of thyroid nodules.
Abstract
Background and Objectives: Iodine is known to be an important factor in the occurrence of goiter, and SouthKorea is a region with sufficient iodine supplementation. In this regard, we checked the size change of thyroidnodules found by health check-up in Koreans and examined which risk factors influence the size change. Materialsand Methods: A total 7753 subjects who underwent thyroid sonography two or more times were included. Wedefined that there was a change in the size of the nodule when the difference in diameter identified in the lastultrasound was more than 3 mm. Results: Thyroid nodules were decreased in 895 subjects (11.5%) and increasedin 1041 subjects (13.5%). The rate of increased nodule was on an increasing trend according to the duration(annual percent change 2.6%, p＜0.001). In contrast, the rate of decreased nodule was unchanged. Predictivefactors related to decrease of the nodule size were young age, male sex, larger initial nodule size and thyroiditis. Similarly, young age, larger initial nodule size and diffuse parenchymal abnormality were significant predictivefactors for increased nodules. However, diffuse parenchymal abnormality was not a predictive factor when weanalyzed only thyroid nodules larger than 1 cm. Conclusion: In our study, 11.5-13.5% of benign thyroid noduleswere increased or decreased during median 27 months of follow-up in iodine sufficient condition. Young age,larger initial size and diffuse parenchymal abnormality were common predictive factor affecting both the increaseand decrease of thyroid nodules.
참고문헌 (29)
- Ezzat S, "Thyroid incidentalomas. Prevalence by palpation and ultrasonography", Arch Intern Med, 154(16), pp.1838~1840 (1994)
- Brander A, "Thyroid gland : US screening in a random adult population", Radiology, 181(3), pp.683~687 (1991)
- Tan GH, "Thyroid incidentalomas : management approaches to nonpalpable nodules discovered incidentally on thyroid imaging", Ann Intern Med, 126(3), pp.226~231 (1997)
- Werk EE Jr, "Cancer in thyroid nodules. A community hospital survey", Arch Intern Me, 144(3), pp.474~476 (1984)
- Papini E, "Risk of malignancy in nonpalpable thyroid nodules : predictive value of ultrasound and color-Doppler features", J Clin Endocrinol Metab, 87(5), pp.1941~1946 (2002)
- Moumen M, "Compressive goiters. Apropos of 80 cases", J Chir(Paris), 126(10), pp.521~526 (1989)
- Arora N, "Do benign thyroid nodules have malignant potential? An evidence-based review", World J Surg, 32(7), pp.1237~1246 (2008)
- Haugen BR, "2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer : the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer", Thyroid, 26(1), pp.1~133 (2016)
- 이가희, "2016년 대한갑상선학회 갑상선결절 및 암 진료 권고안 개정안", International Journal of Thyroidology, 9(2), pp.59~126 (2016), 대한갑상선학회
- Quadbeck B, "Long-term follow-up of thyroid nodule growth", Exp Clin Endocrinol Diabetes, 110(7), pp.348~354 (2002)
- Erdogan MF, "Natural course of benign thyroid nodules in a moderately iodine-deficient area", Clin Endocrinol(Oxf), 65(6), pp.767~771 (2006)
- Delange F, "The disorders induced by iodine deficiency", Thyroid, 4(1), pp.107~128 (1994)
- Yu X, "A five-year follow-up study of goiter and thyroid nodules in three regions with different iodine intakes in China", J Endocrinol Invest, 31(3), pp.243~250 (2008)
- 임동준, "Natural Course of Cytologically Benign Thyroid Nodules: Observation of Ultrasonographic Changes", Endocrinology and Metabolism, 28(2), pp.110~118 (2013), 대한내분비학회
- Alexander EK, "Natural history of benign solid and cystic thyroid nodules", Ann Intern Med, 138(4), pp.315~318 (2003)
- Anil C, "Impaired glucose metabolism is a risk factor for increased thyroid volume and nodule prevalence in a mild-to-moderate iodine deficient area", Metabolism, 62(7), pp.970~975 (2013)
- Ayturk S, "Metabolic syndrome and its components are associated with increased thyroid volume and nodule prevalence in a mild-tomoderate iodine-deficient area", Eur J Endocrinol, 161(4), pp.599~605 (2009)
- Blanc E, "Association between worse metabolic control and increased thyroid volume and nodular disease in elderly adults with metabolic syndrome", Metab Syndr Relat Disord, 13(5), pp.221~226 (2015)
- Kim JY, "Dietary iodine intake and urinary iodine excretion in normal Korean adults", Yonsei Med J, 39(4), pp.355~362 (1998)
- Kim TH, "Effect of seasonal changes on the transition between subclinical hypothyroid and euthyroid status", J Clin Endocrinol Metab, 98(8), pp.3420~3429 (2013)
- Ito Y, "An observational trial for papillary thyroid microcarcinoma in Japanese patients", World J Surg, 34(1), pp.28~35 (2010)
- Pedersen OM, "The value of ultrasonography in predicting autoimmune thyroid disease", Thyroid, 10(3), pp.251~259 (2000)
- American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer, "Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer", Thyroid, 19(11), pp.1167~1214 (2009)
- Rago T, "Non-palpable thyroid nodules in a borderline iodine-sufficient area : detection by ultrasonography and follow-up", J Endocrinol Invest, 24(10), pp.770~776 (2001)
- Durante C, "The natural history of benign thyroid nodules", JAMA, 313(9), pp.926~935 (2015)
- Braverman LE, "Werner & Ingbar's the thyroid : a fundamental and clinical text", pp.2013, Wolters Kluwer
- Medeiros-Neto G, "TSH secretion and regulation in endemic goiter and endemic cretinism", Prog Clin Biol Res, 116, pp.119~130 (1983)
- Papini E, "Long-term changes in nodular goiter : a 5-year prospective randomized trial of levothyroxine suppressive therapy for benign cold thyroid nodules", J Clin Endocrinol Metab, 83(3), pp.780~783 (1998)
- 황세나, "Focal Lymphocytic Thyroiditis Nodules Share the Features of Papillary Thyroid Cancer on Ultrasound", Yonsei Medical Journal, 56(5), pp.1338~1344 (2015), 연세대학교의과대학[DOI]