Relationship between thyroid function tests and cytological patterns of thyroid nodules: a hospital-based cross-sectional observational study.

Sailusha Sreerama; Sultana Nadera; Shouri Rama

doi:10.51168/m817hg30

Autori

Sailusha Sreerama Assistant Professor, Department of Biochemistry, Government Medical College, Vikarabad, Telangana, India
Sultana Nadera Assistant Professor Department of Pathology, Government Medical College, Vikarabad, Telangana, India
Shouri Rama Professor and Head, Department of Biochemistry, Government Medical College, Vikarabad, Telangana, India

DOI:

https://doi.org/10.51168/m817hg30

Cuvinte cheie:

Bethesda system, fine-needle aspiration cytology, thyroid nodule, thyroid-stimulating hormone, thyroid function tests

Rezumat

Background

Thyroid nodules are frequently encountered in clinical practice. Although most are benign, fine-needle aspiration cytology is essential for risk classification. Serum thyroid-stimulating hormone has also been investigated as a supplementary marker of cytological and malignant potential.

Objectives

To describe thyroid function and cytological patterns among patients with thyroid nodules and assess the relationship between thyroid function tests and Bethesda cytological categories

Methods

This hospital-based cross-sectional observational study included 80 patients with clinically or radiologically detected thyroid nodules at Government Medical College and Hospital, Vikarabad, Telangana, India, from October 2024 to September 2025. Serum thyroid-stimulating hormone, free thyroxine and free triiodothyronine were measured. Fine-needle aspiration cytology was classified using the Bethesda system. Associations were evaluated using appropriate categorical and non-parametric tests.

Results

The mean age was 44.8 ± 13.2 years, and 62 participants (77.5%) were female. Fifty patients (62.5%) were euthyroid, 21 (26.3%) had hypothyroid patterns and nine (11.3%) had hyperthyroid patterns. Bethesda category II was observed in 52 nodules (65.0%); six nodules (7.5%) had malignant cytology and four (5.0%) were suspicious for malignancy. Median thyroid-stimulating hormone increased from 2.3 mIU/L in benign cytology to 4.1 mIU/L in Bethesda categories III–V and 4.8 mIU/L in malignant cytology. Elevated thyroid-stimulating hormone was associated with non-benign cytology (odds ratio 4.04; 95% confidence interval 1.38–11.87). Free thyroid hormone concentrations were not significantly associated with cytological risk.

Conclusion

Benign nodules and euthyroid status predominated. Higher serum thyroid-stimulating hormone concentrations were associated with increasing cytological risk, supporting their use as an adjunct rather than a substitute for ultrasonography and cytology.

Recommendations

Serum thyroid-stimulating hormone should be interpreted alongside clinical examination, ultrasound risk features and Bethesda category when prioritising evaluation and follow-up of thyroid nodules.

Biografii autori

Sailusha Sreerama, Assistant Professor, Department of Biochemistry, Government Medical College, Vikarabad, Telangana, India

Dr. Sailusha Sreerama is an Assistant Professor in the Department of Biochemistry at Government Medical College, Vikarabad, Telangana, India. Her academic and research interests include clinical biochemistry, metabolic disorders, laboratory diagnostics, and biochemical markers relevant to disease evaluation and prognosis. She is actively involved in undergraduate medical education and research activities. ORCID iD : https://orcid.org/0009-0003-0698-5584
Sultana Nadera, Assistant Professor Department of Pathology, Government Medical College, Vikarabad, Telangana, India

Dr. Nadera Sultana is an Assistant Professor in the Department of Pathology at Government Medical College, Vikarabad, Telangana, India. Her professional interests include histopathology, cytopathology, clinicopathological correlation, and diagnostic pathology. She is engaged in medical teaching, diagnostic services, and research in pathological mechanisms of human disease. ORCID iD : https://orcid.org/0009-0005-2898-0236

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