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Risk of Thyroid Cancer in Euthyroid Asymptomatic Patients with Thyroid Nodules with an Emphasis on Family History of Thyroid Cancer

 Shin Hye Hwang  ;  Eun-Kyung Kim  ;  Hee Jung Moon  ;  Jung Hyun Yoon  ;  Jin Young Kwak 
 Korean Journal of Radiology, Vol.17(2) : 255-263, 2016 
Journal Title
 Korean Journal of Radiology 
Issue Date
Adult ; Aged ; Biopsy, Fine-Needle ; Family ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Sex Factors ; Thyroid Neoplasms/diagnostic imaging* ; Thyroid Neoplasms/pathology ; Thyroid Nodule/diagnostic imaging* ; Thyroid Nodule/pathology ; Thyrotropin/blood
First-degree family history ; Risk factor ; Thyroid cancer ; Ultrasonography
OBJECTIVE: To determine the factors associated with thyroid cancer, focusing on first-degree family history and ultrasonography (US) features, in euthyroid asymptomatic patients with thyroid nodules. MATERIALS AND METHODS: This retrospective study included 1310 thyroid nodules of 1254 euthyroid asymptomatic patients who underwent US-guided fine-needle aspiration biopsy between November 2012 and August 2013. Nodule size and clinical risk factors-such as patient age, gender, first-degree family history of thyroid cancer, multiplicity on US and serum thyroid stimulating hormone (TSH) levels-were considered together with US features to compare benign and malignant nodules. Multiple logistic regression analysis was performed to assess the risk of thyroid malignancy according to clinical and US characteristics. RESULTS: Although all of the clinical factors and US findings were significantly different between patients with benign and malignant nodules, a solitary lesion on US (p = 0.041-0.043), US features and male gender (p < 0.001) were significant independent risk factors for thyroid malignancy in a multivariate analysis. Patient age, a first-degree family history of thyroid cancer and high normal serum TSH levels did not independently significantly increase the risk of thyroid cancer. However, multicollinearity existed between US assessment and patient age, first-degree family history of thyroid cancer and serum TSH values. CONCLUSION: Ultrasonography findings should be the primary criterion used to decide the management of euthyroid asymptomatic patients with thyroid nodules. The concept of first-degree family history as a risk factor for thyroid malignancy should be further studied in asymptomatic patients.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
곽진영(Kwak, Jin Young) ORCID logo https://orcid.org/0000-0002-6212-1495
김은경(Kim, Eun-Kyung) ORCID logo https://orcid.org/0000-0002-3368-5013
문희정(Moon, Hee Jung) ORCID logo https://orcid.org/0000-0002-5643-5885
윤정현(Yoon, Jung Hyun) ORCID logo https://orcid.org/0000-0002-2100-3513
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