Hashimoto Thyroiditis With Nodule: The Clinical Characteristics And Prognostic Risk Factors

Objective: To explore the clinical features of Hashimoto’sthyroditis(HT) co-existing nodules and evaluate the prognostic factors, thenfurther discusses preoperative serum thyroid-stimulating hormone (TSH)level and the relationship between the differentiated thyroid cancer(DTC).Material and Methods: Retrospective analysis of5785patients weretreated by cases of thyroid nodules in Dalian medical university firstaffiliated hospital, from January2002to December2010. All of the patientswith preoperative cervical ultrasound were found nodules and categorisedbased on their final pathological diagnosis. Among all the patients withthyroid nodules included166cases co-existing HT. Through the analysis ofsome prognostic predictors, the age, gender, tumor number, with necklymph node metastasis and preoperative serum TSH level et al, understandtheir relationship with thyroid cancer.Results: There were166patients confirmed by the final pathology forHashimoto’s thyroiditis with nodular goiter or thyroid cancer after surgery. 62cases (8.45%,62/734) were HT with papillary thyroid cancer(PTC), incomparison with HT patients with goiter nodule, the mean age, nodulenumbers, with neck lymph node metastasis and mean TSH level can be usedas a prognostic factor of disease. In addition, along with the elevated TSHlevel may be related to the high incidence of PTC.Conclusion: Ultrasound plays very important role in preoperative diagnosisof thyroid nodule which found intranodular vascularity andmicrocalcification in thyroid cancer has important diagnostic value. The HTpatients co-existing PTC display a greater female preponderance, younger,solitary nodule and higher serum TSH level. The multivariate analysisreveals solitary nodule, some ultrasonic ima ge characteristics likeintranodular vascularity and microcalcification, serum TSH level wereassociated with the increased risk of tumor.