Risk factors for well-differentiated thyroid carcinoma in patients with thyroid nodular disease. |
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| Authors: | S Naweed Raza Manish D Shah Carsten E Palme Francis T Hall Spiro Eski Jeremy L Freeman |
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| Affiliation: | Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, University of Toronto, Toronoto, Canada. razasn@mcmaster.ca |
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| Abstract: | OBJECTIVES: 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. STUDY DESIGN: Retrospective analysis of 600 patients. SUBJECTS AND 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). CONCLUSION: 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. |
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