2011, Number 2
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Cir Cir 2011; 79 (2)
Prevalence of thyroid nodules in the Valley of Mexico
Hurtado-López LM, Basurto-Kuba E, Montes de Oca-Durán ER, Pulido-Cejudo A, Vázquez-Ortega R, Athié-Gutiérrez C
Language: Spanish
References: 28
Page: 114-117
PDF size: 269.24 Kb.
ABSTRACT
Background: There are no open population epidemiological studies to determine the true prevalence of thyroid nodules in the Valley of Mexico. The aim of this investigation was to determine prevalence.
Methods: We carried out a cross-sectional, observational, descriptive study in 2401 open population subjects in the Valley of Mexico. All subjects were at least 18 years of age with no clinical history of thyroid disease. Variables analyzed were age, gender, thyroid nodule identified by neck palpation or neck ultrasound, TSH levels, cytological diagnosis and histopathological diagnosis in case of clinical thyroid nodule detection. Percentages as asummary measure for qualitative variables and proportions and chi-square for independent variables were used for statistical analysis.
Results: Included were 2401 subjects with a mean age of 39 years (82.4% female, 17.6% male). Thirty four (1.4%) thyroid nodules were detected by palpation and 471 (19.6%) by ultrasound. The 34 palpable thyroid nodules corresponded to 16 (47.2%) colloid goiters, 8 (23.5%) follicular adenomas, 7 (20.5%) Hashimoto´s thyroiditis, 2 (5.9%) papillary carcinomas and 1 (2.9%) oxiphilic cell adenoma. Nonpalpable thyroid nodules detected by ultrasound did not develop illness at 2-year follow-up. TSH was normal in 1620 (67.4%), high in 515 (21.5%) and low in 266 (11.1%) patients. There was no relationship between TSH levels and final diagnosis of the 34 palpable nodules (p ›0.05).
Conclusions: Prevalence of palpable thyroid nodule in the Valley of Mexico is 1.4%; 5.9% of these are due to papillary thyroid cancer. TSH levels do not correlate with the presence or cause of the thyroid nodule.
REFERENCES
Vázquez-Enríquez RM, Alcántara-Vázquez A, Alonso-de Ruiz P, Arellano-Montaño AS, Córdova-Ramírez S, Duarte-Torres R, et al. Nódulo tiroideo. Consenso. Cir Gen 2002;24:76-83.
Hegedus L. Clinical practice. The thyroid nodule. N Engl J Med 2004;351:1764-1771.
Bomeli SR, LeBeau SO, Ferris RL. Evaluation of a thyroid nodule. Otolaryngol. Clin North Am 2010;43:229-238.
Tonacchera M, Pinchera A, Vitti P. Assessment of nodular goitre. Best Pract Res Clin Endocrinol Metab 2010;24:51-61.
Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedüs L, et al.; AACE/AME/ETA Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association. Medical guidelines for clinical practicefor the diagnosis and management of thyroid nodules: executive summary of recommendations. Endocr Pract 2010;16:468-475.
Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, et al. 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 2009;19:1167-1214.
Brander A, Viikinkoski P, Tuuhea J, Voutilainen L, Kivisaari L. Clinical versus ultrasound examination of the thyroid gland in common clinical practice. J Clin Ultrasound 1992;20:37-42.
Schneider AB, Bekerman C, Leland J, Rosengarten J, Hyun H, Collins B, et al. Thyroid nodules in the follow-up of irradiated individuals: comparison of thyroid ultrasound with scanning and palpation. J Clin Endocrinol Metab 1997;82:4020-4027.
Gharib H, Papini E, Paschke R. Thyroid nodules: a review of current guidelines, practices, and prospects. Eur J Endocrinol 2008;159:493-505.
Ezzat S, Sarti DA, Cain DR, Braunstein GD. Thyroid incidentalomas. Prevalence by palpation and ultrasonography. Arch Intern Med 1994;154:1838-1840.
Dean DS, Gharib H. Epidemiology of thyroid nodules. Best Pract Res Clin Endocrinol Metab 2008;22:901-911.
Vander JB, Gaston EA, Dawber TR. The significance of nontoxic thyroid nodules. Final report of a 15-year study of the incidence of thyroid malignancy. Ann Intern Med 1968;69:537-540.
Tunbridge WM, Evered DC, Hall R, Appleton D, Brewis M, Clark F, et al. The spectrum of thyroid disease in a community: the Whickham survey. Clin Endocrinol 1977;7:481-493.
López-López JA, Hurtado-López LM, Zaldívar-Ramírez FR, Soto-Abraham MV, Arellano-Montaño S. Frecuencia de la patología quirúrgica tiroidea. Rev Med Hosp Gen Mex 2001;64:137-142.
Gharib H, Papini E. Thyroid nodules: clinical importance, assessment, and treatment. Endocrinol Metab Clin North Am 2007;36:707-735.
Pitoia F, Ward L, Wohllk N, Friguglietti C, Tomimori E, Gauna A, et al. Recommendations of the Latin American Thyroid Society on diagnosis and management of differentiated thyroid cancer. Arq Bras Endocrinol Metabol 2009;53:884-788.
Wong CK, Wheeler MH. Thyroid nodules: rational management. World J Surg 2000;24:934-941.
Wilhelm SM, Robinson AV, Krishnamurthi SS, Reynolds HL. Evaluation and management of incidental thyroid nodules in patients with another primary malignancy. Surgery 2007;142:581-586.
Villegas AS, Hurtado-López LM, Zaldívar-Ramírez FR, Basurto-Kuba E, Muñoz-Solís O, Pulido-Cejudo A, et al. Epidemiología del nódulo tiroideo. Cir Gen 2001;23:283-289.
Zaldívar-Ramírez FR, López-López JA, Hurtado-López LM. Nódulo tiroideo: Frecuencia de malignidad. Cir Gen 2001;23:92-94.
Hurtado-López LM, Arellano-Montaño S, Torres-Acosta EM, Zaldívar-Ramírez FR, Duarte-Torres RM, Alonso-De-Ruiz P, et al. Combined use of fine-needle aspiration biopsy, MIBI scans and frozen section biopsy offers the best diagnostic accuracy in the assessment of the hypofunctioning solitary thyroid nodule. Eur J Nucl Med Mol Imaging 2004;31:1273-1279.
Carrillo JF, Frías-Mendivil M, Ochoa-Carrillo FJ, Ibarra M. Accuracy of fineneedle aspiration biopsy of the thyroid combined with an evaluation of clinical and radiologic factors. Otolaryngol Head Neck Surg 2000;122:917-921.
López LH, Canto JA, Herrera MF, Gamboa-Domínguez A, Rivera R, González O, et al. Efficacy of fine-needle aspiration biopsy of thyroid nodules: experience of a Mexican institution. World J Surg 1997;2:408-411.
WHO, UNICEF, ICCIDD. Global prevalence of iodine deficiency disorders. Micronutrient Deficiency Information system working paper 1. Geneva: World Health Organization; 1993. pp. 25-29. Disponible en http://www. who.int/nutrition/publications/micronutrients/iodine_deficiency/54015_ mdis_workingpaper1/en/index.html
De Benoist B, Andersson M, Egli I, Takkouche B, Allen H, editors. Iodine status worldwide: WHO Global Database on Iodine Deficiency. Geneva: World Health Organization; 2004. pp. 36-33. Disponible en http://whqlibdoc.who.int/publications/2004/9241592001.pdf
Volzke H, Ludemann J, Robinson DM, Spieker KW, Schwahn C, Kramer A, et al. The prevalence of undiagnosed thyroid disorders in a previously iodine-deficient area. Thyroid 2003;13:803-810.