Malignant risk of thyroid nodules with isolated macrocalcifications – A study based on surgery results

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics Pub Date : 2025-01-01 DOI:10.1016/j.clinsp.2025.100657

Xi-Yue Yang , Li-Fang Huang , Yue-Jian Han , Xiao-Xin Cen

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引用次数: 0

Abstract

Objective

To determine the malignancy risk of thyroid nodules with Isolated Macrocalcifications (IMC) based on surgical results and evaluate the postoperative risk of malignant nodules with IMC.

Methods

A total of 46 thyroid nodules with IMC were enrolled from 3680 consecutive patients who underwent thyroidectomy between August 2018 and September 2023. The malignancy risk of IMC nodules, postoperative risk of malignant nodules, and whether the ultrasonic features of IMC (smooth, lobulated, or focal disruption of the anterior margin) were associated with malignancy were investigated. The nodules were further divided into three groups (group A, maximum diameter < 10 mm; group B, maximum diameter of 10‒14 mm and group C, maximum diameter ≥ 15 mm). Differences in malignancy and Lymph Node Metastasis (LNM) risks were also evaluated among the three groups.

Results

The malignancy risk of the IMC nodules was 30.43% (14/46). Four patients developed LNM. Eight nodules were staged as T1aN0M0 and low-risk, whereas six nodules were staged as T1bN1aM0 and intermediate-risk. Focal disruption of the anterior margin of IMC was significantly associated with malignancy. Malignant and LNM risk showed no differences among nodules with different sizes.

Conclusions

IMC nodules with different sizes had a lower intermediate risk of malignancy and exhibited the same aggressive behavior. The cutoff value of these nodules for further Fine Needle Aspiration (FNA) warranted further investigation. Interruption of IMC was more often seen in malignant nodules, and more attention should be paid to these nodules.

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甲状腺结节伴孤立大钙化的恶性风险-基于手术结果的研究

目的根据手术结果判断甲状腺结节伴孤立性大钙化（IMC）的恶性风险，评价其术后发生恶性结节的风险。方法从2018年8月至2023年9月期间接受甲状腺切除术的3680例连续患者中共纳入46例伴有IMC的甲状腺结节。探讨IMC结节的恶性风险、术后恶性结节的风险，以及IMC的超声特征（前缘光滑、分叶状或局灶性破裂）是否与恶性相关。将结节进一步分为3组(A组，最大直径<；10毫米;B组，最大直径10 ~ 14mm； C组，最大直径≥15mm)。同时评估三组患者恶性肿瘤和淋巴结转移（LNM）风险的差异。结果IMC结节的恶性风险为30.43%（14/46）。4例患者发生LNM。8个结节分期为T1aN0M0，低风险，6个结节分期为T1bN1aM0，中风险。IMC前缘局灶性破坏与恶性肿瘤显著相关。不同大小结节的恶性及恶性肿瘤风险无差异。结论不同大小的simc结节发生恶性肿瘤的中间风险较低，且具有相同的侵袭行为。这些结节的进一步细针抽吸（FNA）的临界值值得进一步调查。IMC中断多见于恶性结节，应引起重视。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinics 医学-医学：内科

CiteScore

4.10

自引率

3.70%

发文量

129

审稿时长

52 days

期刊介绍： CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.