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Preoperative anti-thyroid antibodies predict malignancy risk in cytologically indeterminate thyroid nodules: a
Saad M Alqahtani1, Ahmed A Albalawi2, Anas A Asiri3
1Department of Surgery, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia.
Gland Surgery
|January 8, 2026
Summary
Elevated anti-thyroid antibodies and thyroid stimulating hormone (TSH) levels can predict thyroid cancer in indeterminate thyroid nodules. These markers aid surgeons in managing patients with these challenging diagnoses.
Area of Science:
- Endocrinology
- Oncology
- Surgical Pathology
Background:
- Cytologically indeterminate thyroid nodules (CITNs) present diagnostic challenges due to their heterogeneity.
- Predicting thyroid cancer (TC) in CITNs requires reliable prognostic markers.
Purpose of the Study:
- To evaluate the prognostic utility of anti-thyroid antibodies for predicting TC in CITNs.
- To assess the combined predictive value of anti-thyroid antibodies and thyroid stimulating hormone (TSH).
Main Methods:
- Prospective multicenter analysis of surgically treated CITN patients.
- Preoperative measurement of anti-thyroid antibodies (thyroid peroxidase and thyroglobulin antibodies), TSH, and cytological/histological diagnosis.
- Multivariate analysis to identify independent predictors of TC.
Main Results:
- Elevated anti-thyroid antibodies and TSH showed a significant correlation with TC (OR 3.10, P=0.003).
- High levels of one antibody plus elevated TSH also indicated significant TC association (OR 2.25, P=0.04).
- Independent predictors of TC included Bethesda IV diagnoses, Hashimoto's thyroiditis, and TSH >1 mIU/L.
Conclusions:
- Elevated anti-thyroid antibody and TSH levels are effective predictors of TC in CITNs.
- These serological markers can assist endocrine surgeons in patient management strategies.
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