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Binjawhar D, Mohammedsaeed W. The determinants of leptin, angiopoietin like 8, and thyroid hormones levels in Saudi females with type 2 diabetes mellitus: A retrospective study. Medicine (Baltimore) 2024; 103:e39339. [PMID: 39252284 PMCID: PMC11383498 DOI: 10.1097/md.0000000000039339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 07/26/2024] [Indexed: 09/11/2024] Open
Abstract
This study aimed to assess the prevalence of thyroid dysfunction, as measured by hormone levels, in Saudi women with type 2 diabetes mellitus (T2DM). The study will also assess thyroid hormones and leptin, angiopoietin like 8 (ANGPTL8), obesity, and cardiovascular diseases (CVD) in T2D patients. A total of 250 women aged 40 to 60 years with T2DM were retrospectively studied between 2021 and 2022. This research examined medical records for T2DM patients. In this investigation, no T2DM patients had thyroid autoantibodies in their medical records. These patients were chosen for their FT4 and TSH values. All participants were Saudi females with T2DM, aged 54.5 years. Of the 250 participants, 32% had hypothyroidism, 14.8% had hyperthyroidism, and 40.8% (102) had no thyroid disease. Hypothyroidism (7.8 ± 0.67 mmol/L) exhibited greater fasting blood glucose (FBG) levels than hyperthyroidism (7.1 ± 0.64 mmol/L) (P < .05). Hypothyroid and hyperthyroid females had significant differences in high density lipoprotein-cholestrol (HDL-C), triglycerides, triglyceride glucose (TyG) index, body mass index (BMI), waist circumstance (WC), high-sensitivity C-reactive protein (hs-CRP), leptin, ANGPTL8, insulin resistance (IR), and insulin levels (P < .05). Pearson's correlation test showed that T2DM patients' HDL-C levels were favorably but negatively correlated with leptin and ANGPTL8 levels. In hypothyroidism, thyroid stimulation hormone (TSH) is favorably linked with glycated hemoglobin (HbA1c), triglyscride (TG), TyG index, BMI, WC, leptin, ANGPTL8, hs-CRP, and IR. T2DM is linked to thyroid malfunction, notably hypothyroidism, which correlates positively with TSH. TSH variations due to increasing leptin, ANGPTL8, and TyG index may enhance the risk of insulin resistance diseases, such as obesity and CVD, in Saudi females with T2DM.
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Affiliation(s)
- Dalal Binjawhar
- Department of Chemistry, College of Science, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Walaa Mohammedsaeed
- Department of Clinical Laboratory Science, Faculty of Applied Medical Science at Taibah University, Al Madinah, Saudi Arabia
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Edzie EKM, Dzefi‐Tettey K, Brakohiapa EK, Nimo O, Appiah‐Thompson P, Amedi MK, Bockarie A, Quarshie F, Onimole E, Akorli E, Anthony R, Edzie RA, Amankwa NA, Amartey A, Osei B, Oppong B, Asemah AR, Gorleku PN. Evaluation of the ultrasound findings of thyroid gland enlargement in Cape Coast Teaching Hospital, Ghana: A retrospective cross-sectional study. Health Sci Rep 2024; 7:e2090. [PMID: 38736473 PMCID: PMC11082088 DOI: 10.1002/hsr2.2090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 03/25/2024] [Accepted: 04/14/2024] [Indexed: 05/14/2024] Open
Abstract
Background and Aim Goiter is a major source of morbidity in the world, especially in the developing world, where dietary iodine deficiency, a known cause of this condition, is endemic. The diagnosis is mostly by ultrasonography (USG) scan, which can give anatomical, pathological, and functional information for the management of goiter. This study aimed to determine the commonest ultrasound findings of goiter in Ghana. Method The records of all 213 patients with goiter diagnosed by USG scan over a 5-year period were retrieved. Data collected were sociodemographics, ultrasound features, thyroid nodules diameter, and Thyroid Imaging Reporting and Data System (TI-RADS) scores, which were analyzed using GNU PSPP, version 1.2.0-3. χ 2 and two-tailed independent samples t-test were also employed, with p ≤ 0.05. Results A total of 213 patients with goiter diagnosed by USG scan were obtained over the study period. The mean age of the participants was 50.01 ± 17.27 years, with an age range of 16-92 years and females constituting the majority (82.16%). The commonest ultrasound features were well-defined solid nodules. The lesion sites for most patients were the whole thyroid (28.17%), both lobes (24.41%), and the right lobe (20.19%). The mean difference in sizes of cysts and solid nodules among genders was 0.26 (CI: -0.14 to 0.67, p = 0.20) and 0.12 (CI: -0.43 to 0.66, p = 0.67), respectively. The TI-RADS score featured TI-RADS 4 (36.62%), TI-RADS 1 (28.17%), TI-RADS 3 (25.82%), TI-RADS 5 (5.16%), and TI-RADS 2 (4.23%). Solid nodules (49.32%, p = 0.001) and cysts (35.71%, p = 0.003) were more common within 41-60 years and less frequent in those <21 years. A p ≤ 0.05 was considered significant in this study. Conclusion The predominant ultrasound features were well-defined solid nodules, simple cysts, and solid nodules with cystic changes, mostly located in the entire thyroid gland and least located in the isthmus only. Cysts and solid nodules were mostly seen in the 41-60 years age group.
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Affiliation(s)
- Emmanuel Kobina Mesi Edzie
- Department of Medical ImagingSchool of Medical Sciences, College of Health and Allied Sciences, University of Cape CoastCape CoastGhana
- Ghana College of Physicians and Surgeons, Faculty of RadiologyAccraGhana
| | - Klenam Dzefi‐Tettey
- Ghana College of Physicians and Surgeons, Faculty of RadiologyAccraGhana
- Department of RadiologyKorle Bu Teaching HospitalAccraGhana
| | | | - Obed Nimo
- Department of Imaging Technology and SonographyCollege of Health and Allied Sciences, University of Cape CoastCape CoastGhana
| | - Peter Appiah‐Thompson
- Department of Ear Nose and ThroatSchool of Medical Sciences, College of Health and Allied Sciences, University of Cape CoastCape CoastGhana
| | - Michael Kofi Amedi
- Ghana College of Physicians and Surgeons, Faculty of RadiologyAccraGhana
- Ghana College of Physicians and Surgeons, Faculty Board of RadiologyAccraGhana
| | - Ansumana Bockarie
- Department of Internal MedicineSchool of Medical Sciences, College of Health and Allied Sciences, University of Cape CoastCape CoastGhana
| | - Frank Quarshie
- African Institute for Mathematical Sciences (AIMS)SantoeGhana
| | - Emmanuel Onimole
- Department of Family MedicineSchool of Medical Sciences, College of Health and Allied Sciences, University of Cape CoastCape CoastGhana
| | - Emmanuel Akorli
- Department of Family MedicineSchool of Medical Sciences, College of Health and Allied Sciences, University of Cape CoastCape CoastGhana
| | - Richard Anthony
- Department of Internal MedicineTema General Hospital, Ghana Health ServiceTemaGhana
| | - Richard Ato Edzie
- Department of Medical ImagingSchool of Medical Sciences, College of Health and Allied Sciences, University of Cape CoastCape CoastGhana
| | - Nana Ama Amankwa
- Ghana College of Physicians and Surgeons, Faculty of Internal MedicineAccraGhana
| | - Aaron Amartey
- Ghana College of Physicians and Surgeons, Faculty of HematologyAccraGhana
| | - Bernard Osei
- African Institute for Mathematical Sciences (AIMS)SantoeGhana
| | - Bright Oppong
- Department of Medical ImagingSchool of Medical Sciences, College of Health and Allied Sciences, University of Cape CoastCape CoastGhana
| | - Abdul Raman Asemah
- Department of Medical ImagingSchool of Medical Sciences, College of Health and Allied Sciences, University of Cape CoastCape CoastGhana
| | - Philip Narteh Gorleku
- Department of Medical ImagingSchool of Medical Sciences, College of Health and Allied Sciences, University of Cape CoastCape CoastGhana
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Alzahrani HA. Malignancy in a Solitary Thyroid Nodule: A Retrospective Histopathological Evaluation. Int J Gen Med 2024; 17:135-140. [PMID: 38249618 PMCID: PMC10799641 DOI: 10.2147/ijgm.s445734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/10/2024] [Indexed: 01/23/2024] Open
Abstract
Objective This study aimed to assess the presence and type of malignancy in patients who underwent thyroid surgery for solitary thyroid nodules. Methods A retrospective review was performed of the case notes of all adult patients with solitary thyroid nodules who underwent thyroid surgery from 1 January 2019 to 31 October 2022. All patients had solitary thyroid nodules identified by ultrasonography. The electronic records of our pathology department were used to determine the pathological diagnosis. Results Forty-two patients with solitary thyroid nodules underwent thyroid surgery. The mean age at presentation was 39.1 ± 12.6 years, and 76.2% of patients were female. The malignancy rate was 31%. Further histopathological analysis found that malignant solitary thyroid nodules were mostly papillary carcinoma. Conclusion This study indicates that solitary thyroid nodules should be evaluated thoroughly and treated with a high index of suspicion because they have a high chance (31%) of being malignant.
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Affiliation(s)
- Hassan A Alzahrani
- Department of Surgery, College of Medicine, King Khalid University, Abha, Saudi Arabia
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Abutalib MA, Shams A, Tamur S, Khalifa EA, Alnefaie GO, Hawsawi YM. Metastatic papillary thyroid carcinoma in pleural effusion: a case report and review of the literature. J Med Case Rep 2023; 17:521. [PMID: 38115146 PMCID: PMC10731747 DOI: 10.1186/s13256-023-04265-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 11/14/2023] [Indexed: 12/21/2023] Open
Abstract
INTRODUCTION Papillary thyroid carcinoma accounts for the most common type of thyroid cancer of well-differentiated type. Papillary thyroid carcinoma is featured by biologically low-grade and less aggressive tumors with a survival rate of 10 years in most of the diagnosed cases. Papillary thyroid carcinoma can be presented with the involvement of cervical lymph nodes in about 50% of the patients, yet distant spread is very uncommon. CASE PRESENTATION Herein, we discuss a Saudi male patient in his early 50s with a history of papillary thyroid carcinoma who presented to the emergency department complaining of shortness of breath and a radiological finding of hydrothorax. Cytologic examination together with immune-histochemical staining and molecular studies of pleural effusion aspiration concluded the definitive diagnosis of metastatic papillary thyroid carcinoma in the pleural space. CONCLUSIONS Papillary thyroid carcinoma seldom causes metastatic niches in the pleural space; this is a rare clinical presentation, nevertheless, a differential diagnosis of thyroid metastasis needs to be excluded. A definitive diagnosis of metastatic papillary thyroid carcinoma can be made using clinical presentation, cytologic examination, immunohistochemical investigation, and molecular testing. The most common mutation found in papillary thyroid carcinoma cases is the V600E mutation found in the BRAF gene, yet these patients have a relatively low probability of cancer recurrence. Patients with papillary thyroid carcinoma who have the BRAF mutation frequently experience metastases and relapses of the disease after the cancer has progressed aggressively. To help with therapy planning and the introduction of BRAF inhibitors, genetic testing for BRAF mutation may therefore prove to be a useful tool, especially in cases of aggressive subtypes of TC.
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Affiliation(s)
- Mohammed Ali Abutalib
- Clinical Cytologist and Supervisor of Pathology, Department of Laboratory Medicine and Pathology, Division of Anatomical Pathology, King Abdulaziz Medical City, P.O.Box 9515, 21423, Jeddah, Saudi Arabia
- King Abdullah International Medical and Research Center, Jeddah, Saudi Arabia
| | - Anwar Shams
- Department of Pharmacology, College of Medicine, Taif University, P.O. Box 11099, Taif, 21944, Saudi Arabia.
- Centre of Biomedical Sciences Research (CBSR), Deanship of Scientific Research, Taif University, Taif, 21974, Saudi Arabia.
- High Altitude Research Center, Taif University, P.O. Box 11099, Taif, 21944, Saudi Arabia.
| | - Shadi Tamur
- Department of Pediatric, College of Medicine, Taif University, P.O. Box 11099, 21944, Taif, Saudi Arabia
| | - Eman A Khalifa
- Department of Parasitology, College of Medicine, Taif University, P.O. Box 11099, 21944, Taif, Saudi Arabia
- Department of Parasitology, Tanta University, Tanta, Egypt
| | - Ghaliah Obaid Alnefaie
- Department of Pathology, College of Medicine, Taif University, P.O. Box 11099, 21944, Taif, Saudi Arabia
| | - Yousef M Hawsawi
- Research Center, King Faisal Specialist Hospital and Research Center, P.O. Box 40047, Jeddah, 21499, Kingdom of Saudi Arabia
- College of Medicine, Al-Faisal University, P.O. Box 50927, 11533, Riyadh, Saudi Arabia
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Nganga ML, Mweya CN. Neglected massive multinodular goiter during pregnancy with dyspnea and successful normal delivery: A case report. Clin Case Rep 2023; 11:e8303. [PMID: 38084351 PMCID: PMC10710524 DOI: 10.1002/ccr3.8303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/05/2023] [Accepted: 11/27/2023] [Indexed: 10/16/2024] Open
Abstract
Key Clinical Message Prompt coordinated care enables vaginal delivery for severe goiter-induced airway compression in late pregnancy when expectant management is precluded. Abstract Long-standing neglected multinodular goiter rarely causes life-threatening airway compression in late pregnancy. Most cases report cesarean delivery to relieve respiratory distress. Vaginal birth may also be possible, but the evidence is limited. A 30-year-old woman with a 7-year goiter history developed severe dyspnea at 34 weeks gestation. Despite the risks, labor was induced by urgent decompression. She vaginally delivered a premature but healthy infant. Her breathing improved after delivery. She later underwent an uncomplicated thyroidectomy. With careful selection and monitoring, vaginal delivery can be considered for goiter-induced respiratory compromise when expectant management is precluded. This case demonstrates successful urgent decompression and favorable maternal-fetal outcomes are possible with a coordinated approach despite the high-risk scenario.
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Affiliation(s)
- Maguzu L. Nganga
- Department of Obstetrics and GynaecologyMbeya Zonal Referral HospitalMbeyaTanzania
- Mbeya College of Health and Allied SciencesUniversity of Dar es SalaamMbeyaTanzania
| | - Clement N. Mweya
- Mbeya College of Health and Allied SciencesUniversity of Dar es SalaamMbeyaTanzania
- Mbeya Medical Research CentreNational Institute for Medical ResearchMbeyaTanzania
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Alqahtani SM. Cytological patterns of thyroid lesions in Najran, Saudi Arabia: A 5-year retrospective study. Saudi Med J 2022; 43:735-742. [PMID: 35830995 PMCID: PMC9749690 DOI: 10.15537/smj.2022.43.7.20220223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 05/28/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To assess the cytological pattern of thyroid lesions in Najran, Saudi Arabia. METHODS A retrospective study, from the period of January 2015 to December 2019. All patients with thyroid enlargement who were presented to different hospitals in Najran and assessed by fine needle aspiration cytology were included in this study. RESULTS Of 1353 cases, 1138 (84.1%) were female and 215 (15.9%) were male. Most of the thyroid lesions were benign (72.5%) including follicular nodules (39.5%), Hashimoto's disease (21.2%), and colloid nodules (11.8%). There were 107 (7.9%)cases of suspicious malignancy, and the most common malignant tumor was papillary carcinoma (10.2%). The 2nd age group (21-40 years) was the common age to be diagnosed with malignant tumors, particularly in males. The 3rd age group (41-60 years) was most affected by thyroid lesions, particularly in females. CONCLUSION Most of thyroid lesions in Najran were benign, and females were more affected by thyroid lesions than males. However, papillary carcinoma was the 4th most frequent thyroid lesion in females, while it was the 2nd most frequent in males and diagnosed mainly in younger males (21-40 years). Finally, ages 21-60 years were associated with most of the thyroid lesions in both males and females.
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Affiliation(s)
- Saad M. Alqahtani
- From the Department of Pathology, College of Medicine, Najran University Hospital, Najran University, Najran, Kingdom of Saudi Arabia
- Address correspondence and reprint request to: Dr. Saad M. Alqahtani, Department of Pathology, College of Medicine, Najran University Hospital, Najran University, Najran, Kingdom of Saudi Arabia. E-mail: ORCID ID: https://orcid.org/0000-0002-3871-6747
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Profile of Male Breast Cancer in Makkah Region of Saudi Arabia: A 4-Year Retrospective Analysis of Radiology and Histopathology. Int J Breast Cancer 2022; 2022:8831011. [PMID: 35784659 PMCID: PMC9242822 DOI: 10.1155/2022/8831011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 05/08/2022] [Accepted: 05/26/2022] [Indexed: 11/18/2022] Open
Abstract
Background Mammography is a method widely used for the diagnosis of breast disorders in women and may help detect breast cancer in its early stages. Male breast cancer often remains undiagnosed or is poorly controlled until serious complications arise; therefore, the use of screening methods is needed to help with early diagnosis. Methods From a total of 1,667 registered mammography cases screened, 17 male breast disease cases were included in this study. Mammography and ultrasound data were analyzed by Statistical Package of Social Sciences v.22 (SPSS). Diagnosis was made following biopsy in suspicious cases, and histopathological and immunological findings of all such patients were obtained for final diagnosis. Results The mean age of the patients was 35 years (range, 14-70 years); 17.6% of the cases were aged 37 yrs, and 2 cases were aged 51 and 52 yrs. Of the 17 cases, 11 had breast lesions, and skin thickening was observed in only 1 case. The different patterns of lesions detected were asymmetry of the parenchyma, mastitis, and hamartoma (n = 1 each), malignant lesions (n = 2), and gynecomastia (n = 6). According to the BI-RADS categorization, 8 cases were benign, one case was probably benign, and 2 cases were likely malignant. In the 2 cases with malignant lesions, pathological diagnosis was made after hematoxylin and eosin and immunocytochemistry examination as invasive ductal carcinoma (IDC) of no special type (NST), grade II and grade III. Conclusions Most breast lesions in this study population were benign, while IDC was the most common malignancy encountered. Mammography is currently the most accurate and cost-effective method for detecting breast lesions. The findings of our study may help increase awareness of male breast cancer and encourage Saudi men at risk to perform self-breast exam and undergo routine breast screening.
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The Risk of Developing Lymphoma among Autoimmune Thyroid Disorder Patients: A Cross-Section Study. DISEASE MARKERS 2022; 2022:4354595. [PMID: 35692889 PMCID: PMC9187447 DOI: 10.1155/2022/4354595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/06/2022] [Accepted: 05/16/2022] [Indexed: 11/20/2022]
Abstract
Background Graves' disease (GD) and Hashimoto's thyroiditis (HT) are the most common types of autoimmune thyroid diseases (AITD), and both are characterized by the infiltration of lymphocytes into the thyroid gland. Moreover, autoimmune diseases like HT have a higher risk of developing lymphoma. This study is aimed at assessing the prevalence and association of lymphoma in patients with AITD. Methods This cross-sectional study was conducted in King Abdulaziz Medical City, Jeddah, Saudi Arabia. Data were gathered from the medical records of patients aged 18 years or older who developed AITD. A total number of 140 medical records were collected, and 72 patients were included after applying in exclusion criteria. Data on the subtype, clinical-stage, treatment modality, patient status, remission, and relapse were collected for patients who developed lymphoma. Results Among 72 patients who developed AITD, HT was diagnosed in 58 (80.6%) patients and GD in 14 (19.4%). Five (7%) patients were diagnosed with lymphoma all of whom had a history of HT. The subtypes of lymphoma were diffuse large B-cell lymphoma (DLBCL 3; 4.2%), follicular lymphoma 1 (1.4%), and Hodgkin's lymphoma 1 (1.4%). Conclusion The prevalence of PTL in patients with AITD, specifically HT, was 7%. Most patients developed NHL, with DLBCL being the most common subtype. The onset of lymphoma in this study was lower than reported in the literature. All patients with PTL had HT in their backgrounds. Further national studies are warranted to explore the relationship between the two diseases to provide more insight into the comprehension of this association.
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Alyousif H, Sid Ahmed MA, Al Saeed A, Hussein A, Musa IE. Diagnostic Reliability of the American College of Radiology Thyroid Imaging Reporting and Data System in Royal Commission Hospital, Kingdom of Saudi Arabia. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND: The American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) classified and predicted the risk of thyroid nodule malignancy with ultrasound scan scoring system.
AIM: Hence, we aimed to investigate the value of the combined use of ultrasound ACR TI-RADS scoring and ultrasound-guided thyroid fine needle aspiration cytology (FNAC) based on the Bethesda System for Reporting Thyroid Cytology (TBSRTC) for assessing the accuracy tests of diagnosing low and high-risk thyroid nodules of ACR TI-RADS.
METHODS: We enrolled 392 patients with thyroid nodules who underwent ultrasound scanning and scoring using the ACR TI-RADS classification along with ultrasound-guided thyroid FNAC and scoring with TBSRTC. The two methods were grouped as low and high risk of malignancy to evaluate the accuracy of ACR TI-RADS.
RESULTS: Three hundred and ninety-two patients were enrolled in the study. The mean (Standard deviation [SD]) age was 46.03 (13.96) years, 332 (84.7%) were females and the mean (SD) of body mass index was 31.90 (22.32) kg/m2 and Vitamin D 17.65 (11.15) nmol/L. The mean (SD) for thyroid function test was 5.37 (44.16) mmol/L for thyroid-stimulating hormone, 1.48 (1.49) ng/dL for free thyroxine (FT4), and 2.69 (0.70) nmol/L for free triiodothyronine (FT3). Most of the participants were euthyroid (63.8%), but 28.6% had hypothyroidism and 7.7% had hyperthyroidism. The accuracy tests of ACR TI-RADS in relation to TBSRTC, were sensitivity (87.8%), specificity (65.2%), positive predictive value (29.8%), and negative predictive value (97%). The area under the curve = 0.590, 95% CI = 0.530–0.650, p ˂ 0.006.
CONCLUSION: ACR TI-RADS is a simple, practical, and reliable scoring system for assessing thyroid nodule; it has a better overall diagnostic performance and the ability to exclude unnecessary FNAC with high negative predictive value.
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Alyousif H, Adam I, Alamin NA, Sid Ahmed MA, Al Saeed A, Hassoni AH, Musa IR. The prevalence and associated predictors for Bethesda III-VI for reporting thyroid cytopathology in Royal Commission Hospital, Kingdom of Saudi Arabia. Ther Adv Endocrinol Metab 2022; 13:20420188221122486. [PMID: 36111207 PMCID: PMC9469765 DOI: 10.1177/20420188221122486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 08/04/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Thyroid cancer is increasing globally and is currently the most prevalent endocrine malignancy. Recent data show an increase in the incidence of thyroid cancer in the Kingdom of Saudi Arabia (KSA). Thyroid ultrasound and fine-needle aspiration cytology (FNAC) are the cornerstones in managing thyroid nodules. We conducted this study to evaluate the prevalence and the associated predictors for thyroid nodule Bethesda III-VI in eastern KSA. METHODS A retrospective study was conducted between January 2015 and 31 August 2021. The participants were recruited patients who received a thyroid ultrasound and ultrasound-guided thyroid FNAC, using the thyroid imaging reporting and data system (TI-RADS) and the Bethesda Classification, respectively. RESULT Three hundred and ten patients who underwent thyroid FNAC were enrolled in the study. The median (interquartile, IQR) age was 47.0 (20.0) years, and 266 (85.8%) of them were females. The median (IQR) body mass index was 30.2 (7.6) kg/m2. Out of these participants, 64.8% were euthyroid, 27.4% had hypothyroidism and 7.7% had hyperthyroidism. The ACR TI-RADS-3, 4 and 5 were 51.3%, 46.1% and 2.6%, respectively. The Bethesda outcome of thyroid FNAC I-VI was 5.2%, 63.9%, 15.5%, 5.8%, 3.5% and 6.1%, respectively. The risk for malignancy (Bethesda III-VI) was documented in 31.0% and atypia of undetermined significance was most prevalent (15.5%). A higher ACR TI-RADS score was associated with a higher risk of malignancy: ACR TI-RADS-3 (20.8%), ACR TI-RADS-4 (39.2%) and ACR TI-RADS-5 (87.5%). In a multivariate analysis, only the ACR TI-RADS score was significantly associated with the outcome of thyroid FNAC: ACR TI-RADS-4 [OR = 2.59 (95% CI = 1.54-4.36)] and ACR TI-RADS-5 [OR = 29.03 (95% CI = 3.44-245.07)]. CONCLUSION There was a high prevalence of Bethesda III-VI and atypia of undetermined significance was most prevalent. A thyroid ultrasound report for TI-RADS was significantly associated with the outcome of thyroid FNAC and is a reliable tool in the absence of molecular testing for thyroid cancer.
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Affiliation(s)
- Hussain Alyousif
- Royal Commission Hospital at AL Jubail Industrial City, Al Jubail, Kingdom of Saudi Arabia
| | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia
| | | | - Mona A. Sid Ahmed
- Royal Commission Hospital at AL Jubail Industrial City, Al Jubail, Kingdom of Saudi Arabia
| | - Ayat Al Saeed
- Royal Commission Hospital at AL Jubail Industrial City, Al Jubail, Kingdom of Saudi Arabia
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Alkaff HH, Besharah BO, Bukhari DH, Sayed SI, Alessa MA, Abdelmonim SK, Alghamdi SA, Alghamdi FE, Abu Suliman OA, Abi Sheffah FR, Al-Tammas AH, Al-Zahrani RA, Marglani OA, Heaphy JC, Bawazir OA, Alherabi AZ. Thyroid neoplasm in Makkah region, Saudi Arabia. A retrospective epidemiological study. Saudi Med J 2021; 41:1330-1335. [PMID: 33294891 PMCID: PMC7841587 DOI: 10.15537/smj.2020.12.25575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives: To improve our local data and demographics of thyroid neoplasm in Makkah region, Kingdom of Saudi Arabia and provide some basic statistics for future studies in our local community. Methods: A record based retrospective epidemiological study was conducted and included 314 thyroid disease patients who were presented to our centers at Makkah region, Kingdom of Saudi Arabia between December 2009 and December 2019. Results: A descriptive statistical analysis was carried out. The average age was 42.77 years, with a female-to-male ratio of 3:1, and most of the patients were Saudi (77%). Fifty-seven percent of cases were benign, while in malignant cases, 33.4% were papillary thyroid carcinoma. The mean follow-up time was 15.44 months, with excellent compliance in 39.4% of the patients. Conclusion: Thyroid tumors have a leading incidence in head and neck tumors in Makkah, Kingdom of Saudi Arabia, mandating further studies to determine the causes and distribution in other regions of the country.
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Affiliation(s)
- Haddad H Alkaff
- Head and Neck & Skull Base Surgery Center, King Abdullah Medical City, Makkah, Kingdom of Saudi Arabia. E-mail.
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Alqahtani WS, Almufareh NA, Domiaty DM, Albasher G, Alduwish MA, Alkhalaf H, Almuzzaini B, Al-Marshidy SS, Alfraihi R, Elasbali AM, Ahmed HG, Almutlaq BA. Epidemiology of cancer in Saudi Arabia thru 2010-2019: a systematic review with constrained meta-analysis. AIMS Public Health 2020; 7:679-696. [PMID: 32968686 PMCID: PMC7505779 DOI: 10.3934/publichealth.2020053] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 09/01/2020] [Indexed: 12/12/2022] Open
Abstract
Background Cancer is emerging as a major global health-care system challenge with a growing burden worldwide. Due to the inconsistent cancer registry system in Saudi Arabia, the epidemiology of cancer is still dispersed in the country. Consequently, this review aimed to assemble the epidemiological metrics of cancer in Saudi Arabia in light of the available published data during the period from (2010–2019). Methods Published literature from Saudi Arabia relating to cancer incidence, prevalence, risk factors, and other epidemiological metrics were accessed through electronic search in Medline/PubMed, Cochrane, Scopus, Web of Knowledge, Google Scholar, and public database that meet the inclusion criteria. Relevant keywords were used during the electronic search about different types of cancers in Saudi Arabia. No filters were used during the electronic searches. Data were pooled and odds ratios (ORs) and 95% confidence interval (95%CI) were calculated. A random-effects meta-analysis was performed to assess the well-determined risk factors associated with different types of cancers. Results The most common cancers in Saudi Arabia are breast, colorectal, prostate, brain, lymphoma, kidney and thyroid outnumbering respectively. Their prevalence rates and OR (95%CI) as follow: breast cancer 53% and 0.93 (0.84–1.00); colon-rectal cancer (CRC) 50.9% and 1.2 (0.81–1.77); prostate cancer 42.6% and 3.2 (0.88–31.11); brain/Central Nervous System cancer 9.6% and 2.3 (0.01–4.2); Hodgkin and non-Hodgkin's lymphoma 9.2% and 3.02 (1.48–6.17); kidney cancer 4.6% and 2.05 (1.61–2.61), and thyroid cancer 12.9% and 6.77 (2.34–19.53). Conclusion Within the diverse cancers reported from Saudi Arabia, the epidemiology of some cancers magnitude 3-fold in the latest years. This increase might be attributed to the changing in the Saudi population lifestyle (adopting western model), lack of cancer awareness, lack of screening & early detection programs, social barriers toward cancer investigations. Obesity, genetics, sedentary lifestyle, tobacco use, viral infection, and iodine & Vit-D deficiency represent the apparent cancer risk factors in Saudi Arabia.
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Affiliation(s)
| | - Nawaf Abdulrahman Almufareh
- Department of Pediatric Dentistry and Preventive Dental Sciences, Riyadh Elm University, Riyadh, Saudi Arabia
| | | | - Gadah Albasher
- King Saud University, Department of Zoology, College of Science, Saudi Arabia
| | - Manal Abduallah Alduwish
- Prince Sattam bin Abdulaziz University, College of Science and Humanities, Biology Department, Alkarj, Saudi Arabia
| | - Huda Alkhalaf
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Bader Almuzzaini
- King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | | | - Rgya Alfraihi
- Pharm B, Pharmacy Services, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Abdelbaset Mohamed Elasbali
- Department of Clinical Laboratory Sciences, College of Applied Medical sciences, Jouf University, Qurayyat, Saudi Arabia
| | - Hussain Gadelkarim Ahmed
- College of Medicine, University of Hail, Saudi Arabia.,Department of Histopathology and Cytology, FMLS, University of Khartoum, Sudan
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Al-Sharafi BA, AlSanabani JA, Alboany IM, Shamsher AM. Thyroid cancer among patients with thyroid nodules in Yemen: a three-year retrospective study in a tertiary center and a specialty clinic. Thyroid Res 2020; 13:8. [PMID: 32518593 PMCID: PMC7275581 DOI: 10.1186/s13044-020-00082-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 06/02/2020] [Indexed: 12/18/2022] Open
Abstract
Background The prevalence of thyroid cancer is increasing worldwide. No previous data are available on the prevalence of thyroid cancer in Yemen. We performed this study to determine the prevalence of thyroid cancer among patients with thyroid nodules in Yemen. Methods A retrospective chart review was performed for 550 patients with thyroid nodules who underwent fine needle aspiration and/or thyroid surgery at a private endocrine clinic and at an endocrine clinic in a tertiary hospital in Yemen over a 3 -year period from October 2016–2019. The prevalence of thyroid cancer; the sonographic findings, Bethesda classification, age, sex, thyroid stimulating hormone (TSH) levels of the patients; and the nodule size and number were reviewed. Results A total of 550 charts were reviewed [501 females (91.1%) and 49 males (8.9%)]. The thyroid cancer prevalence among the patients was 13.8% (CI = 10.9–16.7), and the mean age of the patients was 38.5 years (SD = 12.2). The TSH level and the rate of cancer were significantly related (P = 0.01), but no significant difference in the prevalence of thyroid cancer was found between females (13.4%) and males (18.4%) (P = 0.334). When correlating the rate of cancer with the ultrasound guided fine needle aspiration (UG-FNA) result, those with Bethesda system category III and IV, V and VI had malignancy rates of 20.8, 27.2, 52.4 and 69.2%, respectively. Thyroid nodules highly suspicious for malignancy on ultrasound had a 70% cancer diagnosis rate. The most common thyroid cancer was papillary cancer (71%), followed by follicular cancer (23.7%). Among those undergoing surgery, 44.2% had thyroid cancer, and 5.2% had a premalignant diagnosis. Conclusion Thyroid cancer has a higher prevalence in Yemen than in other middle eastern countries. Our study also reports a higher rate of follicular thyroid cancer than that in other published data, which has to be confirmed by further studies. The malignancy and premalignant diagnosis rate was ~ 50% in our patients who underwent surgery. Many centers in Yemen still do not perform FNA before thyroid surgery. It is important that other centers in the country start emphasizing the need for FNA before surgery. This will decrease the number of unnecessary surgeries and associated complications.
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Affiliation(s)
| | | | - Ibraheem M Alboany
- Department of Radiology, University of Science and Technology, Sana'a, Yemen
| | - Amani M Shamsher
- Department of Pathology, University of Science and Technology Hospital, Sana'a, Yemen
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14
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Wagieh S, Salman K, Bakhsh A, Talaat O, Al Morsy S, Al-Ezzi M, Hamid G, Al-Juhani N. Retrospective Study of Tc-99m Thyroid Scan in Patients with Graves' Disease: Is There Significant Difference in Lobar Activity? Indian J Nucl Med 2020; 35:122-129. [PMID: 32351266 PMCID: PMC7182335 DOI: 10.4103/ijnm.ijnm_186_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/26/2019] [Accepted: 11/27/2019] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Graves' disease (GD) is the most common cause of hyperthyroidism. It was reported that the right thyroid lobe is generally larger, and it is more likely to be affected by thyroid disorders. The aim of the current study is to verify preferential affection of one of the thyroid lobes and incidence of higher activity of either thyroid lobe in patients with GD through analysis of quantitative data of Tc-99m thyroid scan and possible relation of different thyroid lobar activity to gender, age, and total thyroid uptake (TTU) level. MATERIALS AND METHODS Retrospective analysis of quantitative data of Tc-99m thyroid scan in patients with GD was done. Total and lobar thyroid uptake levels were analyzed and correlated with age, gender, and TTU. RESULTS GD was reported in 222 patients, representing 76.6% of those with hyperthyroidism, women represent 70.3% of patients. The right thyroid lobe uptake (RLU) figures were significantly higher compared to the left in the whole group as well as in women and in young patients (<40 years). This significance was lost in men and in old patients. Equal lobar uptake was found in 11 patients. 138 patients (62.2%) had higher RLU, while the remaining 73 patients (32.8%) had higher left thyroid lobe uptake, with statistically significant difference. This significant difference was found in women and in young patients and was absent in men and old patients. There is an increase in the incidence of patients with higher RLU in association with an increase in TTU. All women with TTU >30% had higher RLU figures. CONCLUSION There is significant preferential thyroid lobar affection in favor of the right thyroid lobe in patients with GD, with significantly higher RLU figures and significantly more incidence of patients with higher right lobar activity. This significance is maintained in women and in young patients and lost in men and old patients. The incidence of higher right thyroid lobe activity also increases in association with increase in TTU. Our results emphasize the value of Tc99m thyroid scan in patients with GD, especially when surgery is the treatment of choice, helping to tailor suitable surgical procedure for each individual patient.
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Affiliation(s)
- Shereen Wagieh
- Department of Radio-Diagnosis and Nuclear Medicine, King Abdullah Medical City, Makkah, Saudi Arabia
- Jeddah Oncology Centre, Jeddah, Saudi Arabia
| | - Khaled Salman
- Research Centre, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Aquib Bakhsh
- Department of Radio-Diagnosis and Nuclear Medicine, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Omnia Talaat
- Department of Nuclear Medicine, National Cancer Institute, Cairo, Egypt
| | - Soha Al Morsy
- Research Centre, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Manal Al-Ezzi
- Department of Medical Physics, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Gihad Hamid
- Department of Medical Physics, King Abdullah Medical City, Makkah, Saudi Arabia
| | - Nasser Al-Juhani
- Internal Medicine Department, East Jeddah Hospital, Jeddah, Saudi Arabia
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15
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Alshoabi SA, Binnuhaid AA. Diagnostic accuracy of ultrasonography versus fine-needle-aspiration cytology for predicting benign thyroid lesions. Pak J Med Sci 2019; 35:630-635. [PMID: 31258566 PMCID: PMC6572947 DOI: 10.12669/pjms.35.3.292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background and Objective Thyroid nodules (TNs) are abnormal growths of thyroid cells that form masses within the thyroid gland. TNs are common, and the importance lies in need to exclude thyroid cancer. This study was intended to evaluate the diagnostic accuracy of ultrasonography for differentiating benign from malignant thyroid lesions in comparison with fine-needle aspiration cytology (FNA cytology). Methods This study involved 133 patients with thyroid lesions. All patients underwent thyroid ultrasonography and ultrasound (US)-guided-FNA cytology and results were compared. Results Out of 133 patients included in this study, the mean age was 41.2±15 years, and 113 (85%) were female. Thyroid lesions were benign in 126 cases (94.7%) and malignant in nine cases (5.3%). Among 124 patients with thyroid lesions diagnosed as benign with US, 122 (98.38%) were confirmed to be benign with FNA cytology, and only 2 (1.6%) were proved to be malignant. Among nine patients with thyroid lesions diagnosed as malignant by US, 5 (55.6%) were confirmed to be malignant by FNA cytology, and 4 (44.4%) were proved to be benign. The US diagnosed benign thyroid lesions with a sensitivity, specificity, positive predictive value, and negative predictive value of 98.38%, 71.42%, 98.38%, and 55.55%, respectively. The results revealed strong compatibility between diagnosis of benign thyroid lesions by the US and proved diagnosis by FNA cytology (p<0.001). Conclusion B-mode ultrasonography is a valuable tool in differentiating benign from malignant thyroid lesions. It can almost always predict the benign nature of thyroid lesions with excellent diagnostic accuracy.
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Affiliation(s)
- Sultan Abdulwadoud Alshoabi
- Sultan Abdulwadoud Alshoabi, MBBS, MD, Department of Diagnostic Radiologic Technology, College of Applied Medical Sciences, Taibah University, Almadinah Almunawwarah, Saudi Arabia
| | - Abdulkhaleq Ayedh Binnuhaid
- Abdulkhaleq Ayedh Binnuhaid, MBBS, MD, Department of Specialized Surgery, Radiology Section, Faculty of Medicine, Hadhramout University, Hadhramout, Republic of Yemen
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Aljabri KS, Bokhari SA, Al MA, Khan PM. An 18-year study of thyroid carcinoma in the western region of Saudi Arabia: a retrospective single-center study in a community hospital. Ann Saudi Med 2018; 38:336-343. [PMID: 30284988 PMCID: PMC6180217 DOI: 10.5144/0256-4947.2018.336] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 08/03/2018] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Thyroid carcinoma (TC) is the ninth most common site of all cancers in women in the world and the second most common malignancy in Saudi Arabia. This reports updates data on the epidemiology of the disease in Saudi Arabia. OBJECTIVE Describe and interpret changes in the frequency of TC to compare with other populations and determine proportions of certain histological types of TC. DESIGN Medical record review. SETTING Military hospital in Jeddah, Saudi Arabia. PATIENTS AND METHODS We reviewed the pathological and clinical records from January 2000 to December 2017 of patients with TC. MAIN OUTCOME MEASURES Frequency and types of TC. SAMPLE SIZE 347 patients. RESULTS Over the 18-year period, out of 456 patients with TC, 347 patients had sufficiently complete records: 275 (79.3%) were female and 72 (20.7%) were male for a female to male ratio of 3.8:1. The mean (SD) age at surgery of all patients was 45.2 (16.0) years. There were 287 (82.7%) cases of papillary TC. The next common malignancy was follicular TC with 32 (9.2%) cases followed by Hurthle cell cancer with 11 (3.2%) cases. Lymphoma was found in only 7 (2%) cases. All TC types occurred at a younger age in females than males except for lymphoma. All TC types occurred with the greatest frequency in the fourth and fifth decades. There was a 2.3-fold increase in the number of TCs from 8 (2.3%) in 2000 to 26 (7.5%) in 2017. The rate per 100000 residents of Jeddah increased for the period from 2000 to 2002 from 1.6 to 3.4 for 2015-2017. Papillary TC cases in females accounted for most of the increase. CONCLUSION Our findings are consistent with similar studies worldwide. Etiological factors promoting the rise in TC must be investigated and may provide insight in developing suitable management strategies for the Saudi population. LIMITATION Small sample size and retrospective over a long period. CONFLICT OF INTEREST None.
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Affiliation(s)
- Khalid S Aljabri
- Dr. Khalid S. Aljabri, Department of Endocrinology,, King Fahd Armed Forces Hospital,, PO Box 6572, Jeddah 24361,, Saudi Arabia, T: +966-555-544919, khalidsaljabri@ yahoo.com, ORCID: http://orcid. org/0000-0001-5831-5935
| | | | - Muneera A Al
- Dr. Khalid S. Aljabri, Department of Endocrinology,, King Fahd Armed Forces Hospital,, PO Box 6572, Jeddah 24361,, Saudi Arabia, T: +966-555-544919, khalidsaljabri@ yahoo.com, ORCID: http://orcid. org/0000-0001-5831-5935
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