Elif ÖZDEMİR, Abdussamed YALCIN, Cevdet AYDIN, Reyhan ERSOY, Bekir ÇAKIR, Hüsniye BASER, Neslihan CUHACI, Didem ÖZDEMİR

TOKSİK NODÜLER VE MULTİNODÜLER GUATRLI HASTALARDA TİROTROPİN RESEPTÖR ANTİKORU TİROİD KANSERİ İLE İLİŞKİLİ DEĞİLDİR

Amaç: Graves hastalarında tiroid kanser sıklığı ve agresifliği ile yüksek tirotropin reseptör antikor (TRAb) düzeyleri arasında ilişki bildirilmiştir. Bu ilişki toksik nodüler guatr (TNG) ve toksik multinodüler guatrlı (TMNG) hastalarda araştırılmamıştır. Biz, TNG ve TMNG’li hastalarda, tiroid kanseri ile TRAb arasındaki ilişkiyi araştırmayı amaçladık. Materyal ve Metot: TNG ve TMNG nedeniyle tiroidektomi olan hastalar retrospektif olarak değerlendirildi. Toplam 370 hastadan, TRAb düzeyi mevcut olan 191 TMNG ve 30 TNG hastası çalışmaya dahil edildi. Bulgular: 221 TNG/TMNG’li hastanın 24’ünde (%10,86) TRAb pozitif bulundu. Histopatolojik değerlendirmede, 71 (%32,13) hasta malign, 150 (%67,87) hasta benigndi. 71 malign hastanın 7’sinde (%9,86) ve 150 benign hastanın 17’sinde (%11,33) TRAb pozitifti (p=0,742). Yaş, cinsiyet, serum tirotropin, serbest triiodotironin, serbest tiroksin düzeyleri, anti-tiroid peroksidaz ve anti-tiroglobulin antikor pozitifliği ile histopatolojik tümör tipi açısından TRAb pozitif ve negatif hastalar arasında fark yoktu (sırasıyla p=0,393, p=0,401, p=0,403, p=0,903, p=0,877, p=0,788, p=0,540 ve p=0,357). TRAb pozitif 7 (%29,17) hastada ve TRAb negatif 57 (%28,93) hastada papiller tiroid kanseri (PTK) saptandı (p=0,357). Klasik varyant PTK, TRAb pozitif 5 (%71,43) hastada ve TRAb negatif 50 (%87,72) hastada mevcuttu (p=0,242). Sonuç: Bu çalışmada, TMNG/TNG’li hastalarda TRAb pozitifliğinin malignite riskini artırmadığı görüldü.

THYROTROPHIN RECEPTOR ANTIBODY IS NOT ASSOCIATED WITH THYROID CANCER IN PATIENTS WITH TOXIC NODULAR AND MULTINODULAR GOITER

Objectives: Increased thyrotrophin receptor antibody (TRAb) was associated with thyroid cancer risk andaggressivity in patients with Graves disease. This relation was not investigated in patients with toxic nodulargoiter (TNG) and toxic multinodular goiter (TMNG). We aimed to evaluate association between TRAb andthyroid cancer in patients with TNG and TMNG.Materials and Methods: Patients who underwent thyroidectomy with a preoperative diagnosis of TNG andTMNG were reviewed retrospectively. Among 370 patients, TRAb was available in 191 TMNG and 30 TNGpatients.Results: TRAb was positive in 24 (10.86%) of 221 patients with TNG/TMNG. Histopathological result wasmalignant in 71 (32.13%) and benign in 150 (67.87%) patients. TRAb was positive in 7 (9.86%) of 71 malignantand 17 (11.33%) of 150 benign patients (p=0.742). Age, sex, serum thyrotrophin, free triiodothyronine, freethyroxine, anti-thyroid peroxidase and anti-thyroglobulin positivity, and histological tumor type did not differbetween patients with positive and negative TRAb (p=0.393, p=0.401, p=0.403, p=0.903, p=0.877, p=0.788,p=0.540, and p=0.357, respectively). There was papillary thyroid cancer (PTC) in 7 (29.17%) patients withpositive TRAb and 57 (28.93%) patients with negative TRAb (p=0.357). The variant of PTC was classical in 5(71.43%) patients with positive and 50 (87.72%) patients with negative TRAb (p=0.242).Conclusion: In this study, we showed that TRAb positivity did not increase the risk of malignancy in patientswith TNG/TMNG.

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