FNAC-Based Evaluation of Thyroid Lesions: Significance of Hematological and Biochemical Parameters in Untreated Hyperthyroid Patients

Abstract

Objective: To assess thyroid lesions and biochemical alterations in untreated hyperthyroid patients.

Study Design: Hospital based observational cross-sectional study

Place and Duration of Study: This study was conducted at the MINAR Cancer Hospital, Multan from January 2023 to December 2024.

Methods: A total of 1,000 thyroid disorder patients were enrolled at MINAR Cancer Hospital, South Punjab, Pakistan. Clinical evaluation and thyroid function tests (TFTs) identified 272 hyperthyroid patients, 325 euthyroid
controls, and 403 with other thyroid disorders. FNAC was performed in 403 cases and categorized using the Bethesda system. Thyroid scans showed predominantly low radioiodine uptake, enabling stratification into hyperthyroid and FNAC groups. Hematological indices, including WBC, RBC parameters, platelet count, and MPV, were assessed. Statistical analyses employed One-way ANOVA, Student’s t-test, Chi-square, Pearson, and
Spearman correlations, with p<0.05 considered significant.

Results: FNAC analysis showed 35.60% of patients with colloid nodule (Bethesda II), 18.18% with follicular neoplasm (Bethesda IV), 23.07% suspicious for malignancy (Bethesda V), and 18.8% malignant (Bethesda VI). Malignancy was more frequent in patients above 45 years, while residence near the hospital had no effect on malignancy distribution. Hematological findings in untreated hyperthyroid patients revealed significant changes in RBC (p=0.004), MPV (p=0.000), and platelet count (p=0.000). Correlation analysis demonstrated negative associations of T4 with HGB, HCT, MCV, and MCH, and a positive association of MPV with T4 across different subgroups.

Conclusion: FNAC classifies thyroid lesions cytologically, while hematological and biochemical parameters reveal systemic changes, aiding diagnosis and treatment planning independently.