KHẢO SÁT NỒNG ĐỘ TSH, FT3, FT4 Ở NGƯỜI CÓ NHÂN GIÁP THEO PHÂN LOẠI TIRADS (THYROID IMAGING REPORTING AND DATA SYSTEMS) VÀ HỆ THỐNG BETHESDA

Abstract

Background: Thyroid nodules are a common thyroid disease, with approximately 5-7% of cases having the potential to be malignant. The TIRADS and Bethesda classification systems are essential tools for stratifying the risk of thyroid cancer. The role of thyroid-stimulating hormone (TSH) as a predictor of malignancy in people with thyroid nodules remains controversial and has limited research. Method: A cross-sectional descriptive study was conducted on 257 patients (≥18 years old) with thyroid nodules who were diagnosed and followed up at the University of Medicine and Pharmacy Hospital, Ho Chi Minh City in 2024. Ultrasound results, classified according to ACR TIRADS 2017, and fine needle aspiration (FNA) results, classified according to Bethesda 2017, were retrospectively collected from medical records. These records also included a history of thyroid disease treatment and blood test indices assessing TSH, FT3, and FT4 concentrations. Results: The study included 194 women (75.5%) and 63 men (24.5%), with a mean age of 45 ± 13 years. The study population was high-risk for thyroid cancer, with 93% of patients classified as TIRADS 4 or 5 and 93.4% classified as Bethesda V or VI. However, thyroid function in the majority of participants remained within normal limits, with median TSH levels of 1.3 mIU/L (interquartile range, 0.8–1.9), FT3 of 5.0 pmol/L (interquartile range, 4.5–5.5), and FT4 of 10.4 pmol/L (interquartile range, 5.5–15.8). Statistical analysis found no significant differences in TSH, FT3, and FT4 levels between the TIRADS and Bethesda subgroups. Conclusion: The study did not find a statistically significant association between thyroid hormone levels and TIRADS and Bethesda risk categories. The results are consistent with previous publications, emphasizing the important role of ultrasound and FNA in the diagnosis and prognosis of thyroid cancer risk.