ĐẶC ĐIỂM NHÂN TUYẾN GIÁP VÀ TẾ BÀO HỌC Ở NGƯỜI THỪA CÂN, BÉO PHÌ TẠI BỆNH VIỆN BẠCH MAI

Abstract

Introduction: Obesity increases the risk of thyroid nodule formation and is associated with malignant biological features through mechanisms such as insulin resistance, hyperleptinemia, and hormonal dysregulation. Objectives: (1) To describe the clinical, paraclinical, and cytological characteristics of thyroid nodules (TNs) in overweight and obese individuals; (2) To investigate factors associated with thyroid malignancy in this population. Methods: A prospective cross-sectional descriptive study. Results: The study included 191 overweight and obese patients with 193 thyroid nodules. The mean age was 50.45±12.09 years, and 74.9% were female. Common comorbidities included hypertension (22.5%), diabetes mellitus (10.5%), and dyslipidemia (31.9%). A family history of thyroid cancer was reported in 5.2%. Among females, increased waist circumference and waist-to-hip ratio (WHR) indicating metabolic risk were found in 76.2% and 73.4%, respectively. Clinically, all patients were euthyroid. On ultrasound, the median nodule size was 9.3±6.7 mm, with multinodular goiter present in 67%. Sonographic features included multiple locations (3.4%), solid composition (80.8%), hypoechogenicity (74.1%), extrathyroidal extension (4.1%), microcalcifications (13.5%), and taller-than-wide shape (18.7%). Fine-needle aspiration (FNA) based on the 2018 Bethesda system revealed category II in 65.3%, category V in 16.1%, and category VI in 9.8%. Factors significantly associated with thyroid cancer included age group, family history of thyroid cancer, nodule size <10 mm, solid composition, hypoechogenicity, extrathyroidal extension, microcalcifications, and taller-than-wide shape (P<0.05). Conclusion: In overweight and obese patients, a notable proportion of thyroid nodules were classified as Bethesda category V and VI. Thyroid cancer was significantly associated with age, family history of thyroid cancer, smaller nodule size (<10 mm), and suspicious ultrasound features (TIRADS 4–5).