Risk factors for malignancy in patients with solitary thyroid nodules and their impact on the management

Presently it is difficult to differentiate malignancy for thyroid nodules by palpation, ultrasonography and fine-needle aspiration cytology (FNAC) at the outpatient department, especially for solitary thyroid nodule (STN). So a great emphasis should be placed on the STN.

The objective of this study was to investigate the predictive clinicopathological risk factors for malignancy in patients with STN and further to provide an appropriate clinical management.

The records were reviewed from 265 patients with STN who had undergone thyroidectomy in our hospital. All cases were classified as two independent groups in terms of the final pathological results to assess the independent risk factors using a multinomial logistic regression analysis.

A multinomial logistic analysis revealed that the male gender, microcalcification and cervical lymphadenopathy were independent risk factors related to malignancy in patients with STN. The incidence of malignancy in patients with 0,1,2,3 risks was 10.71%, 26.6%, 61.43%, and 100%, respectively.

Male gender, microcalcification and lymphadenopathy were independent risk factors for predicting the malignancy in patients with STN. Patients with more than two of those risk factors should be subjected to further examination or thyroidectomy. The findings may provide a simple and reasonable management for the STN.