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2014, Number 2

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Rev Cuba Endoc 2014; 25 (2)

Prevalence and characterization of the thyroid nodule and the diffuse goiter in an urban area

Bustillo ME, Bustillo SE, Denis CH

Language: Spanish
References: 58
Page: 87-103
PDF size: 193.62 Kb.


ABSTRACT

Introduction: thyroid nodule disease is a health problem in the adult population due to its high incidence. The diagnosis has improved in the last few decades as a result of the thyroid computer tomography. Previous research studies to analyze the situation of this disease and of diffuse goiter in the adult population did not exist in Sancti Spiritus province, so the prevalence study was conducted in Jatibonico city.
Objective: to determine the prevalence of the thyroid nodule disease and of diffuse goiter in the adult populations from 3 physician's offices located in Jatibonico urban area as well as to determine the personal and family histories, the clinical picture of presentation, the ultrasonographic signs and the value of the thyroid-stimulating hormone in those people with thyroid nodule and diffuse goiter.
Methods: the universe of study was an 18 years-old and over population of both sexes from 3 randomly selected physician's offices located in the urban area of Jatibonico (n= 6 126 people). The estimated sample for 95 % confidence interval was 337 persons and a total number of 405 individuals were surveyed. All of them were performed thyroid computer tomography. The thyroid-stimulating hormone was detected in 277 people. They were then classified into subjects having and not having the disease, and at the same time, there was sub-classification into thyroid nodule disease and diffuse goiter.
Results: the prevalence of thyroid disease in the studied population was 41.97 % (CI- 95 %: 37.17-46.77 %). The sub-classification yielded the presence of thyroid nodule disease in 36.79 % of subjects (CI- 95 %: 32.09-41.48 %) and of diffuse goiter in 5.18 % (CI- 95 %: 3.02-7.33 %), respectively. The majority of patients suffering from this disease was asymptomatic (85.3 %) and distributed into all the age groups, with slight predominance of females. The high (32.85 %) and the subnormal (7.58 %) thyroid-stimulating hormones were detected in the studied patients.
Conclusions: in the study population, the prevalence of the thyroid nodule disease was higher than that of the diffuse goiter.


REFERENCES

  1. Hegedus L. Clinical practice: the thyroid nodule. N Engl J Med. 2004;351(17):1764-71.

  2. 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(3):537-40.

  3. Ezzat S, Sarti DA, Cain DR, Braunstein GD. Thyroid incidentalomas: prevalence by palpation and ultrasonography. Arch Intern Med. 1994;154(16):1838-40.

  4. Wang C, Crapo LM. The epidemiology of thyroid disease and implications for screening. Endocrinol Metab Clin North Am. 1997;26(1):189-218.

  5. Turcios Tristá SE, Yanes Quesada M, Cruz Hernández J, Rodríguez González JC. Actualización de la conducta diagnóstica en el nódulo de tiroides. Rev Cubana Endocrinol. 2010;21(3):333-9.

  6. Navarro Despaigne D. Epidemiología de las enfermedades del tiroides en Cuba. Rev Cubana Endocrinol [serie en Internet]. Abr 2004 [citado 27 de noviembre de 2013];15(1). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561- 29532004000100004&lng=es&nrm=iso&tlng=es

  7. Pereiras Costa R, Jequin Savariego E. Actualidad del ultrasonido en las enfermedades del tiroides. Rev Cubana Endocrinol [serie en Internet]. Abr 2004 [citado 27 de noviembre de 2013];15(1). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1561- 29532004000100008&lng=es&nrm=iso&tlng=es

  8. Singer PA, Cooper DS, Daniels GH, Ladenson PW, Greenspan FS, Levy EG, et al. Treatment guidelines for patients with thyroid nodules and well-differentiated thyroid cancer. American Thyroid Association. Arch Intern Med. 1996;156(19):2165-72.

  9. Mazzaferri EL. Management of a solitary thyroid nodule. N Engl J Med. 1993;328(8):553-9.

  10. Frates MC, Benson CB, Doubilet PM, Cibas ES, Marqusee E. Can color Doppler sonography aid in the prediction of malignancy of thyroid nodules? J Ultrasound Med. 2003 Feb;22(2):127-31.

  11. Brander AE, Viikinkoski VP, Nickels JI, Kivisaari LM. Importance of thyroid abnormalities detected at US screening: a 5-year follow-up. Radiology. 2000;215(3):801-6.

  12. Carroll BA. Asymptomatic thyroid nodules: incidental sonographic detection. Am J Roentgenol. 1982;138(3):499-501.

  13. Hurtado-López LM, Basurto-Kuba E, Montes de Oca-Durán ER, Pulido-Cejudo A, Vázquez-Ortega R, Athié-Gutiérrez C . Prevalence of thyroid nodules in the Valley of Mexico. Cir Cir. 2011;79(2):114-7.

  14. Pezzolla A, Lattarulo S, Milella M, Barile G, Pascazio B, Ciampolillo A, et al. Incidental carcinoma in thyroid pathology: our experience and review of the literature. Ann Ital Chir. 2010;81(3):165-9.

  15. Londero SC, Krogdahl A, Bastholt L, Overgaard J, Trolle W, Pedersen HB, et al. Danish Thyroid Cancer Group. Papillary thyroid microcarcinoma in Denmark 1996- 2008: a national study of epidemiology and clinical significance. Thyoid. 2013;23(9):1159-64.

  16. Kuo EJ, Goffredo P, Sosa JA, Roman SA. Aggressive variants of papillary thyroid microcarcinoma are associated with extrathyroidal spread and lymph-node metastases: a population-level analysis. Thyroid. 2013;23(10):1305-11.

  17. Virk RK, Van Dyke AL, Finkelstein A, Prasad A, Gibson J, Hui P, et al. BRAFV600E mutation in papillary thyroid microcarcinoma: a genotype-phenotype correlation. Mod Pathol. 2013 Jan;26(1):62-70.

  18. Malandrino P, Pellegriti G, Attard M, Violi MA, Giordano C, Sciacca L, et al. Papillary thyroid microcarcinomas: a comparative study of the characteristics and risk factors at presentation in two cancer registries. J Clin Endocrinol Metab. 2013;98(4):1427-34.

  19. Arora N, Turbendian HK, Kato MA, Moo TA, Zarnegar R, Fahey TJ, et al. Papillary thyroid carcinoma and microcarcinoma: is there a need to distinguish the two? Thyroid. 2009;19(5):473-7.

  20. Zaletel K, Gaberscek S, Pirnat E. Ten-year follow-up of thyroid epidemiology in Slovenia after increase in salt iodization. Croat Med J. 2011;52(5):615-21.

  21. Khajedaluee M, Rajabian R, Seyyednozadi M. Education achievements and goiter size ten years after iodized salt consuming. Int J Prev Med. 2013;4(8):876-80.

  22. Struve CW, Haupt S, Ohlen S. Influence of frequency of previous pregnancies on the prevalence of thyroid nodules in women without clinical evidence of thyroid disease. Thyroid. 1993;3(1):7-9.

  23. Popoveniuc G, Jonklaas J. Thyroid Nodules. Med Clin North Am. 2012;96(2):329-49.

  24. Rezzónico JN, Rezzónico M, Pusiol E, Pitoia F, Niepomniszcze H. Increased prevalence of insulin resistance in patients with differentiated thyroid carcinoma. Metab Syndr Relat Disord. 2009;7(4):375-80.

  25. Rotondi M, Cappelli C, Magri F, Botta R, Dionisio R, Iacobello C, et al. Thyroidal effect of metformin treatment in patients with polycystic ovary syndrome. Clin Endocrinol (Oxf). 2011;75(3):378-81.

  26. Rezzónico J, Rezzónico M, Pusiol E, Pitoia F, Niepomniszcze H. Metformin treatment for small benign thyroid nodules in patients with insulin resistance. Metab Syndr Relat Disord. 2011;9(1):69-75.

  27. Rotondi M, Cappelli C, Leporati P, Chytiris S, Zerbini F, Fonte R, et al. A hypoechoic pattern of the thyroid at ultrasound does not indicate autoimmune thyroid disease in patients with morbid obesity. Eur J Endocrinol. 2010;163(1):105-9.

  28. Ayturk S, Gursoy A, Kut A, Anil C, Nar A, Tutuncu NB. Metabolic syndrome and its components are associated with increased thyroid volume and nodule prevalence in a mild-to-moderate iodine deficient area. Eur J Endocrinol. 2009;161(4):599-605.

  29. Rezzónico JN, Rezzónico M, Pusiol E, Pitoia F, Niepomniszcze H. Increased prevalence of insulin resistance in patients with differentiated thyroid carcinoma. Metab Syndr Relat Disord. 2009;7(4):375-80.

  30. Medeiros de Sousa PA, Vaisman M, Ivar Carneiro JR, Guimarães L, Freitas H, Castellar Pinheiro MF, et al. Prevalence of goiter and thyroid nodular disease in patients with class III obesity. Arq Bras Endocrinol Metab. 2013;57(2):120-5.

  31. Pistelli A, Foddis R, Guglielmi G, Bonotti A, Cristaudo A. Prevalence of thyroid disease in healthcare workers occupationally exposed to ionizing radiation at the University Hospital of Pisa. G Ital Med Lav Ergon. 2012;34(3 Suppl):280-2.

  32. Sinnott B, Ron E, Schneider AB. Exposing the thyroid to radiation: A review of its current extent, risks, and implications. Endocr Rev. 2010;31(5):756-73.

  33. Hegedüs L, Bonnema SJ, Bennedbaek FN. Management of simple nodular goiter: current status and future perspectives. Endocr Rev. 2003;24(1):102-32.

  34. Aydin LY, Aydin Y, Besir FH, Demirin H, Yildirim H, Önder E, et al. Effect of smoking intensity on thyroid volume, thyroid nodularity and thyroid function: the Melen study. Minerva Endocrinol. 2011;36(4):273-80.

  35. Carpi A, Rossi G, Romani R, Di Coscio G, Nicolini A, Simoncini T, et al. Are risk factors common to thyroid cancer and nodule? A forty years observational timetrend study. PLoS One. 2012;7:e47758.

  36. Cooper D, Doherty G, Haugen B, Kloos R, Lee S, Mandel S, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167-214.

  37. Buzduga C, Mogoş V, Găleşanu C, Vulpoi C, Ungureanu MC, Cristea C, et al. Clinical profile of thyroid nodules in Iaşi, Department of Endocrinology, St. Spiridon Hospital, between 2005-2009. Rev Med Chir Soc Med Nat Iasi. 2010;114(4):1005-7.

  38. Alavez E, Ochoa F, Perich P, Romeo de León J. Bocio endémico en Cuba: encuesta en la región de Baracoa. Rev Cubana Hig Epidemiol. 1977;15:123-36.

  39. 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 (Oxf). 1977;7(6):481-93.

  40. Knudsen N, Perrild H, Christiansen E, Rasmussen S, Dige-Petersen H, Jørgensen T. Thyroid structure and size and two-year follow-up of solitary cold thyroid nodules in an unselected population with borderline iodine deficiency. Eur J Endocrinol. 2000;142(3):224-30.

  41. Delange F, de Benoist B, Pretell E, Dunn JT. Iodine deficiency in the world: where do we stand at the turn of the century? Thyroid. 2001;11(5):437-47.

  42. Zimmermann MB. Iodine Deficiency. Endocr Rev. 2009;30(4):376-408.

  43. Cooper DS. Clinical practice. Subclinical hypothyroidism. N Engl J Med. 2001;345(4):260-5.

  44. Biondi B, Cooper DS. The Clinical Significance of Subclinical Thyroid Dysfunction. Endocr Rev. 2008;29(1):76-131.

  45. Cooper DS. Approach to the patient with subclinical hyperthyroidism. J Clin Endocrinol Metab. 2007;92(1):3-9.

  46. Fiore E, Vitti P. Serum TSH and Risk of Papillary Thyroid Cancer in Nodular Thyroid Disease. J Clin Endocrinol Metab. 2012;97(4):1134-45.

  47. Haymart MR, Glinberg SL, Liu J, Sippel RS, Jaume JC, Chen H. Higher serum TSH in thyroid cancer patients occurs independent of age and correlates with extrathyroidal extension. Clin Endocrinol (Oxf). 2009;71(3):434-9.

  48. Rago T, Fiore E, Scutari M, Santini F, Di Coscio G, Romani R, et al. Male sex, single nodularity, and young age are associated with the risk of finding a papillary thyroid cancer on fine-needle aspiration cytology in a large series of patients with nodular thyroid disease. Eur J Endocrinol. 2010;162(4):763-70.

  49. Choi SH, Kim EK, Kim SJ, Kwak JY. Thyroid Ultrasonography: Pitfalls and Techniques. Korean J Radiol. 2014;15(2):267-76.

  50. Gabryel B, Brominski G, Owecki M, Michalak M, Ruchala M. The prevalence of thyroid nodular disease in patients with increased titers of anti-thyroidal peroxidase antibodies. Neuro Endocrinol Lett. 2012;33(4):442-5.

  51. Rio AL, Biscolla RP, Andreoni DM, Camacho CP, Nakabashi CC, Mamone Mda C, et al. Evaluation of clinical, laboratorial and ultrasonographic predicting factors of malignancy in thyroid nodules. Arq Bras Endocrinol Metabol. 2011;55(1):29-37.

  52. Sipos J. Advances in ultrasound for the diagnosis and management of thyroid cancer. Thyroid. 2009;19(12):1363-72.

  53. Sheth S. Role of ultrasonography in thyroid disease. Otolaryngol Clin North Am. 2010;43(2):239-55.

  54. Hong YJ, Son EJ, Kim EK, Kwak JY, Hong SW, Chang HS. Positive predictive values of sonographic features of solid thyroid nodule. Clin Imaging. 2010;34(2):127-33.

  55. Frates MC, Benson CB, Charboneau JW, Cibas ES, Clark OH, Coleman BG, et al. Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. Radiology. 2005;237(3):794-800.

  56. Won-Jin Moon WJ, Jung SL, Lee JH, Na DG, Baek JH, Lee YH, et al. For the Thyroid Study Group, Korean Society of Neuro-and Head and Neck Radiology. Benign and Malignant Thyroid Nodules: US Differentiation-Multicenter Retrospective Study. Radiology. 2008;247(3):762-70.

  57. Papini E, Guglielmi R, Bianchini A, Crescenzi A, Taccogna S, Nardi F, et al. Risk of malignancy in nonpalpable thyroid nodules: predictive value of ultrasound and color-Doppler features. J Clin Endocrinol Metab. 2002;87(5):1941-6.

  58. Shrestha M, Crothers BA, Burch HB. The impact of thyroid nodule size on the risk of malignancy and accuracy of fine-needle aspiration: a 10-year study from a single institution. Thyroid. 2012;22(12):1251-6.




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