Calcifications in thyroid ultrasonography and thyroid carcinoma

@#BACKGROUND: Thyroid nodules are a common disease entity occurring in 5-10% of the general population and increasing with age. Their detection on ultrasonography ranges from 13% to 67%. Calcifications on ultrasound may occur in both benign and malignant diseases but have been cited for increased risk of thyroid carcinoma.OBJECTIVE: To determine the association of calcifications found on thyroid ultrasonography and the different types of calcifications with thyroid carcinoma.METHODS: Design: Retrospective Study Setting: Tertiary Private Hospital Participants: 126 patients with pre-operative thyroid or neck ultrasonography who subsequently underwent thyroidectomy (total or subtotal, with or without frozen section) were selected from a database covering a one-year period from January to December 2012. The presence and type of calcification on ultrasonography was correlated with the final histopathologic report for a diagnosis of thyroid carcinoma. Sensitivity, specificity, positive and negative predictive values were obtained.RESULTS: 51 out of 126 studies (40%) were observed to have calcifications of any description in both histologically benign (41%) and malignant (59%) nodules. Calcifications seen in malignancy arose from papillary carcinoma (86%). Follicular carcinoma and others (Plasmacytoma and Lymphoma) accounted for 7% each. The peripheral type of calcification was most prevalent accounting for 37% (11 out of 30). The sensitivity of detecting calcifications on ultrasonography is 58.82%, specificity 81.33%, positive predictive value 68.18% and negative predictive value 74.38%. Chi square test computed was 21.54 (P <0.05).CONCLUSION: There was an association between calcification found on ultrasonography and thyroid carcinoma and 86% of the calcifications were peripheral patterns mostly found in papillary thyroid carcinomas. Ultrasonography alone is not sufficient in diagnosing thyroid carcinoma but may increase the suspicion of malignancy depending on the type of calcification.

Relationship of dietary intake of omega-3 and omega-6 fatty acids with risk of prostate cancer development: A meta-analyis of cohort studies

OBJECTIVE: To determine the relationship between dietary omega-3 fatty acid(n-3PUFA) and omega-6 fatty acids (n-6PUFA) with prostate cancer risk from a meta-analysis of prospective cohort studies. DESIGN: Cohort studies that investigated the relationship of dietary omega fatty acids and prostate cancer risk were retrieved from MEDLINE, Unbound MEDLINE, EMBASE, OVID, Cochrane Library and Science direct up to June 2011, and were critically appraised using Newcastle-Ottawa Quality Assessment for cohorts. General variance-based method was used to the pool the effect estimates at 95% confidence interval. Heterogeneity was assessed by chi square and quantified by I2. RESULTS: Eight cohort studies were included for meta-analysis. n-3PUFA, n-6PUFA and their derivatives were not significantly associated with risk of prostate cancer in general. A significant heterogeneity (P=0.023,I2=63%) between studies was noted. After inter-study variability adjustment was done, repeat analysis showed a significant negative association between high dietary intake of alpha-linolenic acid(ALA) and prostate cancer risk (pooled RR:0.915;95% CL:0.849, 0.985;P=0.019) Likewise, a slightly positive association was noted on dietary long chain omega-3 fatty acids (EPA+DHA) and prostate cancer risk (pooled RR: 1.135; 95% CI:1.008, 1.278 P=0.036), however when two other cohort studies with data of EPA and DHA both analyzed separately was included into the pool, the association became not significant (RR=1.034;95%CI:0.973,1.096;P=0.2780). CONCLUSION: The intake of n-3PUFA and n-6PUFA does not significantly affect the risk of prostate cancer. High intake of ALA may reduce risk of prostate cancer, while intake of long-chain omega-3 fatty acids does not have a significant effect.