Analysis Of Related Factors Of Benign And Malignant Thyroid Nodules

Objective:To retrospectively analyzed the clinical and pathological data of postoperative of atients with thyroid nodules, detected the related factors of malignant thyroid nodules. Providing the basis for the clinical identification of benign and malignant thyroid nodules. Materials and methods:This study included 912 individuals after thyroid operation in thyroid surgery department of our hospital in Jilin province from October 2014 to September 2015. Postoperative patients were retrospectively analyzed the clinical and pathological data, according to the postoperative pathology were divided into benign nodules group with malignant nodules. The relationship between benign and malignant thyroid nodules with age, sex, smoking, drinking, family history, hypertension, diabetes, thyroid-stimulating hormone, thyroglobulin antibody, thyroid peroxidase antibody, estradiol, and thyroid ultrasound were analyzed. Logistic regression analysis was used to analyze whether the factors were independent risk factors for thyroid malignant nodules. Results:(1) 912 patients after surgical treatment of thyroid nodules, male and female proportion is 1:4. 6. Benign nodules group 314 cases, accounting for 34.4%; Malignant nodules group 598 cases, accounting for 65.6%. Including the most common for differentiated thyroid carcinoma in 593 cases, accounting for 65.0%, followed by 235 cases of nodular goiter, accounting for 25.8%. The average age of malignant nodule group was lower than that of the benign group [(43.10±10.00) vs(52.60±10.33)years old]. According to the age group, between 25 to 74 years old patients, the younger the age, the higher the proportion of malignant nodules. The incidence of malignant nodules in male was lower than that in female, and the difference was statistically significant(P<0.05).(2) The incidence of malignant thyroid nodules in patients with diabetes was higher than that of non diabetics(76.2% vs 64.2%), the difference was statistically significant(P<0.05).(3) Compared with non-smokers and non-drinkers, the smokers and drinkers had low incidence of malignant nodules, the difference was statistically significant(P<0.05).(4) The level of estradiol in malignant nodule group was higher than that in benign nodule group[(369.30±321.960) vs(299.39±276.23) pmol/L], but there was no statistically significant difference(P>0.05).(5) The level of fasting blood glucose in malignant nodule group was higher than that in benign nodule group [(5.88±0.99) vs(5.86±1.51) mmol/L], the difference was statistically significant(P<0.05).(6) The level of TSH in malignant nodule group was higher than that in benign group [(3.04±1.91) vs(2.59±2.17) u IU/ml], the difference was statistically significant(P<0.05). According to the TSH grouping, as TSH level increases, gradually increased the proportion of malignant thyroid nodules. Tg Ab and(or) TPOAb positive patients with malignant nodules prevalence was higher than that of Tg Ab, TPOAb were negative patients, the difference was statistically significant(P<0.05).(7) Thyroid nodules diameter less than 1 cm, aspect ratio >1, the single solid nodules, low echo, unclear boundary, irregular shape, small calcification, rich blood supply, and lymph node enlargement, were risk factors for malignant thyroid nodules.(8) Logistic regression analysis: younger, diabetes, high levels of TSH, nodule diameter less than 1cm, low echo, irregular shape, small calcification, lymph node enlargement were risk factors for malignant thyroid nodules. Smoking was the protective factor for benign thyroid nodules. Conclusion:(1) After surgical treatment of patients with thyroid nodules, postoperative pathology showed malignant nodules more than benign nodules, the most common pathological type was differentiated thyroid cancer, followed by nodular goiter.(2) In patients with thyroid nodules, the younger the age, the greater the possibility of malignant nodules.(3) The proportion of malignant nodules in patients with diabetes mellitus was slightly higher than that of non diabetics.(4) Following ultrasound findings suggested the malignant thyroid nodules: nodules diameter less than 1cm, low echo, irregular shape, small calcification, lymph node enlargement.