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Pre-operative serum TSH level estimation for predicting malignant nodular thyroid disease

Background: the aim of this study was to assess the value of serum thyroid–stimulating hormone (TSH) levels in predicting malignancy in patients with nodular thyroid disease (NTD). Objective: The aim was to examine the relationship between preoperative TSH and differentiated thyroid cancer (DTC).
Patients and Method: all patients with NTD who were admitted in the first surgical unit of Baghdad teaching hospital and assessed for preoperative TSH level before subjecting them for thyroidectomy from first of April 2014 to 31 of January 2016, were included in the study. A preoperative database sheets including Age, gender, nodule size, and pathology were evaluated. Logistic regression analysis was used to determine which factors were predictive of malignancy.
Results: 291 patients were included in our study after exclusion of 20 patients,
Four patients with histopathological results other than differentiated thyroid cancer (anaplastic, medullary carcinoma) and sixteen patients were on thyroxine therapy. The overall rate of malignancy was 11%. The rate was slightly higher at extremes of age .the mean TSH was higher in the malignant group (2.07 vs 1.07, p=0.02). The rate of malignancy was 40% in patients with TSH level > 5.5 μIU/mL. Logistic regression analysis revealed that TSH level was the only significant risk factor for malignancy.
Conclusion: the serum TSH level may be useful in predicting the probability of cancer and optimizing the extent of thyroidectomy in patients with NTD.

 

هدف الدراسة: تقدير مستوى الهرمون المحفز للغدة الدرقية قبل العملية للتنبؤ بوجود السرطان في امراض الغدة الدرقية العقدية.

المرضى والطرق : جميع المرضى الذين يعانون من امراض الغدة الدرقية العقدية الذين تم قبولهم في وحدة الجراحة الأولى من مستشفى بغداد التعليمي وتقييم مستوى الهرمون المحفز للغدة الدرقية(TSH)   قبل إخضاعهم لعملية استئصال الغدة الدرقية ‘ تم ادراجهم في هذه الدراسة من الأول من نسيان 2014 إلى 31 من كانون الثاني 2016.

تم تقييم أوراق قاعدة البيانات قبل الجراحة بما في ذلك العمر والجنس وحجم العقد، و التحليل النسيجي بعد اجراء الجراحة. تم استخدام تحليل الانحدار اللوجستي لتحديد العوامل التنبؤية في ايجاد سرطان الغدة الدرقية المتميز.

النتائج : بعد ادخال مئتان وواحد وتسعون مريض في الدراسة‘ تم استبعاد اربعة مرضى لوجود سرطان الغدة الدرقية غير المتميز في نتائج تحليل الفحص النسيجي النهائي ‘ وتم استبعاد ستة عشر مريض اخرين لتعاطيهم دواء الثايروكسين .

معدل السرطان %11 ، المعدل مرتفع قليلا في نقيض العمرين (اقل من 30 سنة واكثر من سبعين سنة) ، معدل مستوى هرمون  (  (TSHكان اعلى عند مرضى سرطان الغدة الدرقية )  2.07 vs1.07, p=0.02) .

كانت نسبة السرطان  %40 عند المرضى الذين مستوى الهرمون المحفز (TSH) لديهم اكثر من 5.5 µIU/ml .

بين تحليل الانحدار الوجيستي ان مستوى الهرمون المحفز للغدة الدرقية هو العامل الوحيد القادر على تنبئ وجود سرطان الغدة الدرقية المتميز.

الاستنتاجات : تقييم مستوى الهرمون المحفز للغدة قبل العملية مفيد في تنبئ احتمالية وجود سرطان الغدة المتميز وتحسين مستوى استئصال الغدة لدى مرضى الغدة الدرقية العقدية.

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Publication Date
Sun Oct 01 2017
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Publication Date
Sun Sep 02 2018
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Immunohistochemistry on cell blocks a method for pre-operative diagnosis of papillary thyroid carcinoma by FNAC

Background: Papillary thyroid carcinoma (PTC) is the commonest thyroid cancer. Cases in category-
5a of Bethesda system (suspicious for papillary carcinoma) are treated by surgical lobectomy followed
by total thyroidectomy if histopathology confirms papillary carcinoma. In order to reduce surgical
procedures to one this was conducted.
Objectives: evaluation of role of immunohistochemistry in pre-operative diagnosis of papillary thyroid
carcinoma on cell blocks.
Materials and Method: Cell blocks were taken from cases labelled category-5a for histopathology and
immunohistochemistry using three markers (CK-19, Thyro-peroxidase, and BRAFv600E mutation).
Results: were highly sensitive, and specific. The use of more tha

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Publication Date
Sat Dec 07 2019
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Incidental Thyroid Carcinoma in Patients Treated Surgically for Thyroid Disease

Background: The occurrence of incidental thyroid cancer (ITC) has increased by three times during the last decades and this rise could be attributed to many factors. To limit the prevalence of ITC with goiter especially nodular goiter, total thyroidectomy can become a procedure of choice.

Objective: To determine the extent of incidental thyroid carcinoma (ITC) and to plan a proper preoperative diagnostic work up and a convenient operative procedure for patients with different thyroid diseases.


Results:
ITC was found in 77 patients (19.15%). While, 63 patients with non-toxic MNG (15.6%), 12 patients with non-toxic solitary thyroid nodule (3%) and two patients (0.5%) wi

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Publication Date
Sun Oct 02 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Incidental thyroid carcinoma

Background: thyroid carcinoma is the most common endocrine carcinoma as it accounts for almost 90% of all endocrine malignancies. The term incidental denoted malignant tumors of the thyroid gland detected by post-operative biopsy results of the resected specimens resected from benign thyroid diseases. Among the incidental thyroid malignancies, papillary carcinoma is the commonest pathological type.
Objectives : To determine the incidence of incidental thyroid carcinoma and to insist on accurate preoperative diagnostic work up of patients with thyroid diseases.
Patients & Methods: A prospective study, which was conducted during the period from March 2013 to April 2014 at Baghdad teaching hospital first surgical unit by the same

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Publication Date
Sun Nov 08 2020
Journal Name
Journal Of The Faculty Of Medicine Baghdad
the The Role of Ultrasound in the Diagnosis of Malignant Thyroid Nodules

Background: Thyroid nodules are very common in clinical practice. Although most of thyroid nodules are benign, it is crucial to checkout which nodules are more likely to be malignant. Ultrasound is a major diagnostic tool for screening and evaluating thyroid diseases because it is safe, non-invasive, non-radioactive and effective.
Objective: The aim is to identify the role of ultrasound in assessing thyroid nodules and to review various ultrasound criteria predicting malignancy.
Patients and methods: A case series study conducted during the period from January 2015 to February 2016 at the First Surgical Unit, Department of Surgery, Baghdad Teaching Hospital by a team of surgeons. One hundred eighty Patients who underwent surgical i

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Publication Date
Fri Mar 01 2024
Journal Name
Baghdad Science Journal
Exploring the Challenges of Diagnosing Thyroid Disease with Imbalanced Data and Machine Learning: A Systematic Literature Review

Thyroid disease is a common disease affecting millions worldwide. Early diagnosis and treatment of thyroid disease can help prevent more serious complications and improve long-term health outcomes. However, thyroid disease diagnosis can be challenging due to its variable symptoms and limited diagnostic tests. By processing enormous amounts of data and seeing trends that may not be immediately evident to human doctors, Machine Learning (ML) algorithms may be capable of increasing the accuracy with which thyroid disease is diagnosed. This study seeks to discover the most recent ML-based and data-driven developments and strategies for diagnosing thyroid disease while considering the challenges associated with imbalanced data in thyroid dise

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Publication Date
Sun Apr 03 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The incidence of thyroid malignancy in multinodulargoiter in Alkindy teaching hospital.

Back ground: The incidence of malignancy in multi-nodular goiter is thought to be low as compared with solitary thyroid nodule.
Objectives: Identifying incidence of malignancy in multi-nodular goiter.
Patients and Methods: This is a prospective study at Al-kindy teaching hospital from January 2013 to September 2015. 160 patient with multi-nodular goiter were included in the study (132females,28 males)  their ages ranged between 17-75 years with a mean age of 35.88 years. Each of the patients had special form of detailed information including history and physical examination ,results of investigations; all the patients had near total thyroidectomy. All the specimens were fixed in formalin and sent for histo-pathological evaluat

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Publication Date
Mon Jul 01 2013
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Evaluation of the new marker interleukin - 33 in Iraqi female patients with hyperthyroidism.

Background: Hyperthyroidism refers to overactive of thyroid gland leading to excessive synthesis of thyroid hormones and accelerated metabolism in the peripheral tissue.
Objective: The aim of this study is to evaluate a new member of the IL-1 super family of cytokines interleukin-33(IL-33) levels in serum .in order to evaluate its utility as clinical bio marker of autoimmune disease (i.e. hyperthyroidism)
Methods: The present study was conducted on 30 patients from the Iraqi female patients with hyperthyroidism attending Baghdad teaching hospital, in addition to 30 healthy controls. All subjects were (35-65) years old. Parameters measured in the sera of patients and healthy groups, were interleukin -33 (IL-33), Thyroxin (T4), Thyro

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Publication Date
Wed Apr 15 2020
Journal Name
Journal Of The Faculty Of Medicine Baghdad
collision tumor of thyroid gland a case report

collision tumor is the presence of two histopathologically distinct tumors in the same anatomical site.  It is a rare pathology of the thyroid gland that makes diagnosis and treatment challenging.  This is a case report of a collision tumor of the thyroid gland.

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Publication Date
Sun Oct 02 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The predictive value of selected ultrasound features in evaluating malignancy in thyroid nodules

Background: Thyroid ultrasound has been widely used to differentiate benign from malignant nodules; many investigators have tried to point out few ultrasonographic features in order to identify those lesions, which are at a higher risk of malignancy.
Objectives: To evaluate the efficacy of selected conventional ultrasound (US) features of thyroid focal lesions useful for predicting malignancy and establishing indications for fine-needle aspiration cytology (FNAC).
Patients and Methods:Two hundred and four consecutive patients with thyroid nodules who visited the outpatient clinic of the surgical department of Tikrit University teaching hospital for the period from January 2011 to April 2014, and who underwent surgery for clinical s

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