Risk factors for well-differentiated thyroid carcinoma in patients with thyroid nodular disease.
OBJECTIVE
Evaluate current accepted risk factors for well-differentiated thyroid carcinoma, and develop a predictive model to determine one's risk of malignancy given a thyroid nodule.


METHODS
Retrospective analysis of 600 patients.


METHODS
Patients with benign thyroid nodular disease and with well-differentiated thyroid cancer were randomly selected. Patient, clinical, and investigational data were compared by means of univariate and multivariate regression analyses.


RESULTS
Age, regional lymphadenopathy, ipsilateral vocal cord palsy, solid and/or calcified nodules, and an aspiration biopsy being malignant or suspicious predicted for cancer (P < 0.05). Regional lymphadenopathy and vocal cord palsy are perfect predictors of malignancy. Multivariate analysis indicated age, solid and/or calcified nodules, and all fine-needle aspiration biopsy results to be significant in assessing risk (P < 0.05).


CONCLUSIONS
Taking individual risk factors in isolation is not always reliable. Using a predictive model, one can anticipate a patient's risk of malignancy when the diagnosis is unclear.
Raza
S Naweed
SN
Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, University of Toronto, Toronoto, Canada. razasn@mcmaster.ca
Shah
Manish D
MD
Palme
Carsten E
CE
Hall
Francis T
FT
Eski
Spiro
S
Freeman
Jeremy L
JL
D000367:Age Factors; D044963:Biopsy, Fine-Needle; D005260:Female; D006801:Humans; D008206:Lymphatic Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011897:Random Allocation; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000209:etiology*; D016606:Thyroid Nodule / Q000150:complications* / Q000473:pathology; D014826:Vocal Cord Paralysis / Q000209:etiology