Özet:

Purpose: Check-up examinations have gained importance over the past decade and have ranked among the most common reasons for applying for medical assistance to health institutions. Thyroid nodes are often detected during the check-up examination. The aim of our study is to determine the frequency of thyroid nodes and the rate of development of thyroid cancer in individuals who apply for check-up examination and to identify the role of variables in the detection of thyroid cancer. Method: The patient’s computer database records were systematically scanned and accessed to the patient’s records with thyroid ultrasound (USG). Patients with a history of any previously known thyroid disease or thyroid cancer and taking medications for a present thyroid disease were dismissed. The patient group’s demographic information, thyroid USG reports, cytology and histopathology results were recorded by evaluating the levels of free T3 (sT3), free T4 (sT4) and thyroid-stimulating hormone (TSH). The body mass index (VKI) was calculated. The data was analyzed using the SPSS 25 statistical package program. Results: Thirty thousand four hundred and forty-nine check-up patients were assessed by 24,362. Five thousand six hundred and forty-five (23.17%) patients had an accidental thyroid nodule. The average VKI of these patients was 56 ± 2,01 kg/m2, TSH value was 2,87 ± 0,45 mIU/mL, sT3 value was 3,76 ± 0,87 pg/mL and sT4 value was 1,23 ± 0,24 pg/mL. While the average nodule size is 1.31±0,56 mm, 2,936 of the nodules (52,01) were observed as solid nodules, 1,377 (24,39) cystic nodules, 1,332 (23,59) mixed nodules. The nodes were 1.916 (33.94) TIRADS 2, 3.273 (57.98) TIRADS 3,234 (4.31) TIRADS 4a, 114 (1.27) TIRADS 4b, 72 (1.27) TIRADS 4c and 36 (0.63) TIRADS 5 categories. The result of the biopsy was benign of 224 (57.14%) of 392 patients, of 100 (25,51) suspected malignant and of 68 (17.34%) malignant. The ratio of patients diagnosed with papillary thyroid cancer was 63.15%, follicular thyroid cancer was 34.21% and medular thyroid cancer was 2.63%. When the multi-nominal logistical regression analysis was applied to all variables that were meaningful in Univariate analysis, increased VKI was found to be 1.7 times [probability rate (OO): 1.71, 95% confidence range (GA): 1.43-2,96], 1.8 times the female sex [OO: 1.79, (GA): 1.21-2,67], 1.6 times the solid nodular structure [OO: 1.62, (GA): 1.27-3,54], 2.7 times the increased nodular diameter [OO: 2.71 (GA): 1.11-3,31], and 4.7 times the increased TIRADS score [OO: 4.73, (GA): 1.76-7.31] had an increasing effect on the development of thyroid cancer. The main challenge in evaluating and managing thyroid nodes is, on the one hand, avoiding the unsuitable overuse of thyroid US, thyroid biopsy and surgeon, while on the other hand, trying to identify clinically significant malignants. In relation to check-up and diagnosis of thyroid cancer, the data obtained from more detailed studies should be evaluated and remembered that the increase in the incidence of thyroid cancer in the past thirty years may be caused not only by excess diagnosis, but by a real increase in the incidence. On the other hand, when the lymphatic nodes are considered to be uninterrupted early diagnosis of thyroid cancer and can reduce both surgical complications and be protected from the risks of radioactive iodine treatment, it has been established that early diagnosed thyroid cancers are a significant advantage for the healthy population seeking for checkup purposes.

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