BioMed Research International

Research Article

Diagnostics of Thyroid Malignancy and Indications for Surgery in the Elderly and Younger Counterparts: Comparison of 3,749 Patients

Table 2

Distribution of cases according to gender and age parameters. Data were presented as number (percent).


	Female				Male
	<45 years ()	45–<65 years ()	65 years ()	value	<45 years ()	45–<65 years ()	65 years ()	value

Cytological diagnosis according to TBSRTC
Stage II (normotype thyrocytes, lymphocytes, thyroiditis suspicion)	841 (84.5)	1,382 (87.3)	448 (78.7)		151 (84.8)	261 (91.6)	123 (89.1)	0.254
Stage III (AUS/FLUS)	26 (2.6)	34 (2.2)	13 (2.3)		5 (2.8)	4 (1.4)	2 (1.5)
Stage IV (follicular neoplasm)	65 (6.5)	87 (5.5)	50 (8.8)		12 (6.7)	8 (2.8)	3 (2.2)
Stage V (malignancy suspicion)	3 (0.3)	15 (1.0)	21 (3.7)		3 (1.7)	2 (0.7)	4 (2.9)
Stage V (malignancy/lymphoma suspicion)	0 (0.0)	0 (0.0)	2 (0.4)		0 (0.0)	0 (0.0)	0 (0.0)
Stage VI (papillary carcinoma)	59 (5.9)	62 (3.9)	34 (6.0)		7 (3.9)	10 (3.5)	6 (4.4)
Stage VI (medullary carcinoma)	1 (0.1)	4 (0.3)	1 (0.2)		0 (0.0)	0 (0.0)	0 (0.0)

Clinical suspicion of malignancy
No	867 (87.1)	1,416 (89.4)	461 (81.0)		156 (87.6)	265 (93.0)	125 (90.6)	0.157
Yes	128 (12.9)	168 (10.6)	108 (19.0)		22 (12.4)	20 (7.0)	13 (9.4)	0.157

Indication for surgery (out of malignancy)
Trachea compression	278 (32.1)	720 (50.9)	444 (96.3)		46 (30.0)	117 (43.8)	112 (89.6)
Recent tumor/goiter enlargement	205 (23.6)	284 (20)	8 (1.7)		79 (50.0)	49 (18.8)	7 (5.6)
Urgent indication (acute respiratory failure/retrosternal goiter)	0 (0.0)	0 (0.0)	7 (1.5)		0 (0.0)	0 (0.0)	4 (3.2)
Cosmetic indication	384 (44.3)	412 (29.1)	2 (0.4)		31 (20.0)	99 (37.5)	2 (1.6)

Histological follow-up
Benign multinodular goiter	759 (76.3)	1,281 (81.0)	433 (76.1)		131 (73.6)	236 (82.8)	105 (76.1)
Thyroiditis	36 (3.6)	50 (3.2)	20 (3.5)		7 (3.9)	3 (1.1)	2 (1.5)
Follicular carcinoma	7 (0.7)	5 (0.3)	5 (0.9)		0 (0.0)	1 (0.4)	7 (5.1)
Papillary carcinoma	76 (7.6)	96 (6.1)	44 (7.7)		9 (5.1)	18 (6.3)	4 (2.9)
Medullary carcinoma	2 (0.2)	2 (0.1)	3 (0.5)		2 (1.1)	1 (0.4)	0 (0.0)
Undifferentiated thyroid cancer	0 (0.0)	1 (0.1)	6 (1.1)		0 (0.0)	1 (0.4)	1 (0.7)
Secondary malignant tumor	0 (0.0)	1 (0.1)	2 (0.4)		0 (0.0)	0 (0.0)	1 (0.7)
Lymphoma	0 (0.0)	2 (0.1)	6 (1.1)		0 (0.0)	1 (0.4)	0 (0.0)
Squamous cell carcinoma	0 (0.0)	0 (0.0)	1 (0.2)		0 (0.0)	0 (0.0)	0 (0.0)
Adenoma	115 (11.6)	142 (9.0)	47 (8.3)		29 (16.3)	24 (8.4)	18 (13.0)
Abscess	0 (0.0)	1 (0.1)	0 (0.0)		0 (0.0)	0 (0.0)	0 (0.0)

Final diagnosis
Benign	910 (91.5)	1,474 (93.1)	501 (88.1)		167 (93.8)	263 (92.3)	125 (90.6)	0.561
Malignant	85 (8.5)	110 (6.9)	68 (11.9)		11 (6.2)	22 (7.7)	13 (9.4)	0.561

Recurrent goiter
No	995 (100.0)	1,572 (99.2)	472 (83.0)		178 (100.0)	285 (100.0)	130 (94.2)
Yes	0 (0.0)	12 (0.8)	97 (17.0)		0 (0.0)	0 (0.0)	8 (5.8)

TBSRTC: The Bethesda System for Reporting Thyroid Cytology, Second Edition 2010 Bethesda, Maryland; AUS: atypia of undetermined significance; FLUS: follicular lesion of undetermined significance; significant.