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World Journal of Surgical Oncology
Published in: World Journal of Surgical Oncology 1/2014

Open Access 01-12-2014 | Research

Preoperative serum thyroglobulin concentration as a predictive factor of malignancy in small follicular and Hürthle cell neoplasms of the thyroid gland

Authors: Rok Petric, Hana Besic, Nikola Besic

Published in: World Journal of Surgical Oncology | Issue 1/2014

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Abstract

Background

Cytologic examination of a fine-needle aspiration biopsy specimen cannot distinguish between benign and malignant follicular or Hürthle cell neoplasms. Serum thyroglobulin (Tg) concentrations are higher in follicular and Hürthle cell carcinomas than in benign follicular or Hürthle cell tumors, but preoperative measurement of Tg is not recommended for initial evaluation of thyroid nodules. The aim of this study was to find out whether preoperative serum Tg concentration is a predictive factor of malignant disease in patients with a follicular or Hürthle cell neoplasm with a diameter of 2 cm or less.

Methods

From 1988 to 2013, a total of 244 patients (214 female, 30 male, age range 9 to 82 years, median age 52 years) had a surgical procedure at our institute because of follicular or Hürthle cell neoplasms with a tumor diameter of 2 cm or less. In these patients a preoperative concentration of Tg was determined and Tg-autoantibodies were negative. The risk factors for malignancy were identified by a chi-square test and multivariate logistic regression.

Results

The histopathologic diagnoses were carcinoma, adenoma, and benign goiter in 62 (25.5%), 115 (47%), and 67 (27.5%) patients, respectively. The median preoperative Tg concentration in benign tumors, papillary carcinomas, follicular carcinomas, and Hürthle cell carcinomas was 41, 87, 72, and 106 ng/ml (P = 0.05), respectively. The predictive factors for carcinoma shown by the chi-square test were: sex, thyroid volume, and preoperative Tg concentration. The independent predictors of malignancy as shown by multivariate logistic regression were: male sex (odds ratio, 2.57; P = 0.02), and a Tg concentration of more than 80 ng/ml (odds ratio, 2.35; P = 0.005).

Conclusion

The independent predictors of malignancy in follicular or Hürthle cell neoplasms are sex and preoperative Tg concentration.
Appendix
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Metadata
Title
Preoperative serum thyroglobulin concentration as a predictive factor of malignancy in small follicular and Hürthle cell neoplasms of the thyroid gland
Authors
Rok Petric
Hana Besic
Nikola Besic
Publication date
01-12-2014
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2014
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-12-282

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