- Publikační typ
- abstrakt z konference MeSH
Objective: Thyroid nodules are a common finding in the general population. The primary aim of the study was to determine the prevalence of thyroid nodules and cancer found by ultrasound (US) in women who underwent screening for thyroid dysfunction during pregnancy. Design: A double-centric, retrospective, cohort study. Patients and methods: We searched through medical records, including thyroid ultrasonography, of pregnant women who were positively screened for thyroid disorders (using thyroid-stimulating hormone and thyroid antibodies) from an unselected population ('universal screening group', n = 690) and of women who underwent the testing based on the presence of clinical risk factors defined by American Thyroid Association ('case-finding group', n = 249). Results: Prevalence of benign and malignant thyroid nodules was lower in the 'universal screening group' than in the 'case-finding group' (9.9% vs 17.7%, P= 0.002, and 0.9% vs 7.2%, P< 0.001, respectively). Consistently, the thyroid cancer rate was lower among the nodules in the 'universal screening group' than in the 'case-finding group' (8.1% vs 29.0%, P= 0.003). Ultrasound EU-TIRADS (European Thyroid Imaging and Reporting Data System) category ≥4 had a 95.8% sensitivity for thyroid cancer. In palpable nodules, the prevalence of cancer was significantly higher than in the non-palpable ones (44.0% vs 2.2%, P < 0.001). In a multivariate regression analysis, thyroid nodules were associated with a history of infertility and parity. Conclusions: Compared to the data from cancer registries, universal screening allowed detecting thyroid cancer in pregnancy three to five times more frequently, but the cancer rate among nodules (8.1%) did not differ from the common population. US had very good sensitivity for thyroid cancer in pregnancy.
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
Abnormální funkce štítné žlázy se vyskytuje u zhruba 4–4,5 % populace, ale v určitých skupinách (rodinné zatížení, autoimunní onemocnění, těhotné nebo ženy po menopauze) je výskyt častější, cílená vyšetření v těchto skupinách prokazují incidenci 15 % a více. Klinický průběh onemocnění štítné žlázy je různý, od asymptomatického nezávažného onemocnění, které nepotřebuje terapii, až po aktivní chorobu s vážnými důsledky. U některých lidí s autoimunitním onemocněním štítné žlázy zůstává funkce žlázy normální, nicméně vlivem určitých okolností (např. biologické léčby) poruchy funkce mohou nastat. U čtyř členů jedné rodiny demonstrujeme vliv genetiky a u jiného pacienta vliv biologické léčby na funkci štítné žlázy. U pacientů se zvýšeným rizikem se doporučuje vyšetřit nejen hodnoty tyreostimulačního hormonu, ale také tyreoidální autoprotilátky. Pokud je u pacienta nalezena jejich pozitivita, je vhodná dispenzarizace s kontrolami jednou za rok.
The prevalence of abnormal thyroid function is approximately 4 to 4.5% of the population but in certain groups (family burden, autoimmune diseases, pregnant and postmenopausal women), the incidence is higher; targeted examination of these groups reveals incidence of 15% or even more. The presentation and clinical course of thyroid diseases is highly variable, ranging from asymptomatic, indolent disease that may never require therapy to active disease that can lead to serious consequences. In some people with autoimmune thyroid disease, the thyroid function remains normal for their entire life. However, due to special influences (i.e., biological treatment), malfunction may occur. The genetic influence on thyroid disease was shown in four cases in one family. In another patient, the influence of biological treatment on thyroid function was demonstrated. In high‑risk patients, the examination of not only TSH but also thyroid autoantibodies is indicated. In case of deviation, annual surveillance is warranted.
