- The Efficacy of Thyroxine Suppression Therapy in Benign Thyroid Nodules.
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Seog Ki Yun, Chul Hee Kim, Young Sun Kim, Dong Won Byun, Kyo Il Suh, Myung Hi Yoo
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J Korean Endocr Soc. 2000;15(4-5):532-541. Published online January 1, 2001
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 Abstract
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- BACKGROUND
Benign pathologic findings are shown in 800% of thyroid nodules by fine needle aspiration cytology (FNAC) or needle biopsy. About half of these benign nodules are follicular lesions which are presented only as thyroid follicles or thyroid cell clumps. Differential diagnosis of follicular adenoma, follicular carcinoma and adenomatous goiter is impossible by FNAC or needle biopsy. Thyroxine suppression therapy has been performed traditionally in order to discriminate malignant nodules, but few studies are available which confirmed the efficacy of thyroxine suppression therapy in thyroid nodules of those the initial pathologic findings were follicular lesions. So we tried to evaluate the efficacy of thyroxine suppression therapy in benign thyroid nodules and also the incidence of thyroid cancer of the thyroid nosules which were not decreased on thyroxine suppression therapy after surgical resection. METHODS: Total 1027 patients with thyroid nodules were evaluated by FNAC or needle biopsy at Soonchunhyang university hospital from 1990 to 1996. Among 1027 patients, 507 patients showed follicular lesions in FNAC or needle biopsy and they received thyroxine suppression therapy. Thyroid nodule volume was measured before and after thyroxine suppression therapy using ultrasonography. We studied 184 patients who were followed up for more than 1 year. Serial changes of thyroid function tests, thyroid nodule volume, serum thyroglubulin (Tg) level before and after therapy were analyzed. RESULTS: l. In 80 (43.5%) of the 184 patients, nodule volumes decreased more than 50 percent after thyroxine suppression therapy. 2. There was no significant difference in serum T3, T4, TSH levels before and after thyroxine suppression therapy between group I (nodule volume decreased less than 50%) and group II (nodule volume decreased more than 50%). 3. In group II patients, thyroid nodule volumes were decreased continuously at 12 month, 18 month and 30 month after thyroxine suppression (p<0.05). 4. There was no significant difference between the group I and group II in the frequency of multiple thyroid nodules on ultrasonography. 5. Among 37 patients who underwent thyroidectomy, 19 cases (51.4%) were revealed as malignant thyroid nodules (papillary cancer 4 cases, follicular cancer 15 cases). Eighteen cases (48.6%) were revealed as benign thyroid nodules (follicular adenoma 10 cases, adenomatous goiter 8 cases). 6. There was no significant difference in the frequency of multiple nodules on ultrasonography between benign and malignant nodules. CONCLUSION: Our data suggested thyroxine suppression therapy was effective in discriminating malignant thyroid nodules from benign nodules, especially in selecting follicular carcinoma from follicular lesion by FNAC or biopsy.
- Analysis of Daily Intake and Urinary Excretion of Iodine normal Control and Patient with Thyroid Disease.
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Yong Wook Cho, Young Sun Kim, Seung Ho Baick, Do Yeon Oh, Whyui Joon Kim, Myung Wha Kang, Kyung Sook Kim
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J Korean Endocr Soc. 1994;9(4):307-317. Published online November 6, 2019
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Abstract
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- Iodine in physiological dosage is necessary for thyroid hormone. But insufficient or excessive intake of iodine could affect on thyroid function. However, little study is available on the current iodine state in Korea. To evaluate the current state of iodine intake and its effects on thyroid function, we measured the iodine intake, urinary excretion and thyroid status in 67 normal controls and 110 patients with thyroid disease from June 1991 to August 1993.The result were as follows; 1) There were no differences in the physical and daily intake of calorie between controls and patients with thyroid disease. 2) The mean daily intake of iodine was 391.4 ug in normal controls, 695.0 ug in patients with simple goiter, 672.0 ug in hypothyroidism, 453.5 ug in hyperthyroidism, and 297.4 ug in thyroid nodule. 3) The mean urinary iodine excretion was 640 ug/L in normal controls, 875 ug/L in patients with hyperthyroidism, 612 ug/L in thyroid nodule, 563 ug/L in hypothyroidism, and 549 ug/L in simple goiter. 4) There was decreasing tendency of the serum T_3, t_4 and significant increase in TSH concentration in subjects who ingest the dietary iodine above 1000 ug/day compared with the subjects who ingest below 150 ug/day(p<0.05). 5) Subjects who live in coastal area had much intake of iodine(1.8-2.5 times)than those of subjects live in inland area.In conculsion, Korean ingested more iodine than Europian and American but fewer than Japanese. Some of the patients with simple goiter and hypothyroidism patients may associated with excessive ingestion of iodine, but further systemized study will be required.
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