Increased Risk of Thyroid Cancer in Patients with Graves’ Disease and Thyroid Nodules: A Retrospective Analysis

Résumé fourni par la source

Background: Graves’ disease (GD) is an autoimmune disorder frequently associated with thyroid nodules, raising concerns regarding malignancy risk. However, reported cancer prevalence varies widely, and data from Eastern European populations remain limited. This study aimed to evaluate the risk of thyroid cancer in GD patients and to identify clinical predictors of malignancy. Methods: We conducted a retrospective cohort study including 168 patients diagnosed with GD between 2018 and 2022 at a tertiary referral center. Clinical, ultrasonographic, and histopathological data were analyzed. Associations between thyroid nodules and malignancy were assessed using chi-square tests and logistic regression analysis. Results: Thyroid nodules were identified in a substantial proportion of GD patients, and among patients with thyroid nodules who underwent thyroidectomy, thyroid carcinoma was confirmed by histopathological examination in 11 of 42 cases (26.2%). The presence of nodules was significantly associated with malignancy (OR = 4.337, 95% CI: 1.528–7.146, p < 0.001). Increasing age was independently associated with higher cancer risk (r = 0.221, p = 0.004). Papillary thyroid carcinoma (PTC) was the predominant histological subtype, most commonly presenting as early-stage disease (pT1aNxR0). Conclusions: Thyroid nodules were significantly associated with thyroid malignancy in patients with Graves’ disease. In this tertiary referral cohort, papillary thyroid carcinoma was the predominant histological subtype, supporting careful ultrasound evaluation and appropriate cytological assessment of thyroid nodules.

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