A Cross Sectional Study to Assess the Association of Thyroid Autoantibodies with Thyroid Malignancies in a Tertiary Care Hospital in Bangladesh

Abstract

Thyroid cancer is the most common endocrine malignant lesion and its incidence continues to rise. The aim of this study was to assess association between thyroid antibodies and thyroid malignancies. This was a cross sectional study of 120 patients with thyroid nodules undergoing thyroidectomy with recorded preoperative thyroid antibodies [autoantibodies to thyroglobulin (TgAb) and/or thyroid peroxidase (TPOAb)] levels from 2017 to 2018 admitted at the ENT Department of Chittagong Medical College Hospital, Chittagong. Analysis was done to assess the association between preoperative thyroid antibody levels, fine needle aspiration cytology (FNAC) results, type of thyroid surgery and final histopathology. Mean age of the study population was 35.58 years (SD:±11.36). According to the final histopathological diagnosis of the 120 patients 80% were benign and other 20% were malignant. Men are more likely to suffer from thyroid malignancy than women (33.3% versus 18.9%). Multinodules are predominant group than solitary nodule (55% versus 45%). Though the prevalence of thyroid malignancies is more in solitary group than multinodules group (22.2% versus 18.2%) the difference is not statistically significant. Among the benign nodules most of them (88.5%) were nodular goiter and among the malignancies most of them were (80.3%) were papillary thyroid carcinoma. There is moderate agreement between FNA and histopathological diagnosis (kappa is .405). The patients with high TSH level in comparison to low TSH level were significantly associated with thyroid malignancy. The patients with preoperative elevated TgAb (≥ 40IU/mL) has 2.55 times of more chance to have malignant lesion than the patients who has normal TgAb level. The study revealed that elevated level of TgAb may act as an independent prediction factor for thyroid malignancy.