Intranodular Glucose Levels In The Differential Diagnosis Of Thyroid Nodules
Cevdet Aydin1, Serap Soytac Inancli2, Fevzi Balkan1, Ahmet Dirikoc1, Aylin Kilic Yazgan3, Reyhan Ersoy4, Bekir Cakir4
1Ankara Ataturk Education and Training Hospital, Department of Endocrinology and Metabolism, Bilkent, ANKARA, TURKEY
2Near East University, Department of Endocrinology and Metabolism, LEFKOSA, CYPRUS
3Ankara Ataturk Education and Training Hospital, Department of Pathology, Bilkent, ANKARA, TURKEY
4Yıldırım Beyazıt University, Department of Endocrinology and Metabolism, Bilkent, ANKARA, TURKEY
Keywords: Thyroid nodule, glucose, fine needle aspiration biopsy
Aim: Recent studies have shown that GLUT-1 expression in malignant cells increases favoring the increase of glucose in to the cells. Detecting intranodular glucose amount might predict malignancy of the thyroid nodule. The aim of this study was to evaluate the glucose content of thyroid nodules during ultrasonography (US) guided fine needle aspiration biopsy (FNAB).
Patients and Methods: Forty- two patients with ultrasonographic suspicious thyroid nodules were selected from Endocrinology and Metabolism out- patient clinic that were to undergo US-guided FNAB. The nodules which were completely solid or had partial cystic components were included in the study. After fine needle aspiration biopsy the specimens were sent for cytologic evaluation. The needle used during fine needle biopsy was rinsed 3 times with 250 µL serum physiologic solution. The glucose level in the wash out was determined. Serum glucose level was determined simultaneuosly. The ratio of serum glucose level to glucose content of the nodule was determined.
Results: The ratio of serum glucose level/glucose content of the nodule which had benign, malignant and indeterminate cytological results were 64.00±24.00, 52.02±22.00, 67.00±27.70 respectively (p=0.371). Although not statistically significant the ratios of serum glucose level/glucose content of the malignant nodules were lower than the other groups. This suggested that the intranodular glucose content was higher than serum glucose content in the malignant group.
Conclusion: Our study is a preliminary study to show if intranodular glucose content can differentiate a malignant from a benign nodule. Further investigations should be done with larger study groups and more standardized method to measure glucose.