The fine needle aspiration biopsy in patients with thyroid nodules, igf-1 (insulin like growth factor-1) ve igfbp-3 (insulin like growth factor binding protein-3) levels inside of the nodule and serum, faculty of medicine, department of internal medicine thesis, zonguldak, 2013.

Altaş A. The Fine Needle Aspiration Biopsy in Patients with Thyroid Nodules, IGF-1 (Insulin Like Growth Factor-1) ve IGFBP-3 (Insulin Like Growth Factor Binding Protein-3) Levels Inside of the Nodule and Serum, Faculty of Medicine, Department of Internal Medicine Thesis, Zonguldak, 2013. Thyroid nodules are the most common thyroid disorder. Molecular, genetic and environmental factors play role in the etıology. From molecular factors, TSH(Thyroid Stımulatıng Hormon) and certain molecules such as IGF-1,Epidermal Growth Factor and immunoglobulins are thought to be effective. IGF-1 is known to play an active role in proliferation of tirosit by induction of TSH. Therefore, it is accepted that development of goiter in patients with long term elevation of growth hormon is associated with the mitogenic effect of IGF-1. There has been found a lot of evidence that there is an interaction between Growth hormone/ IGF axle and TSH. Elevated IGF-1 levels have been detected in benign and malign thyroid tumors in many clinical researchs. In our research, we aimed to dedicate inside of nodule and serum levels of IGF-1 and IGFBP-3 in patients who have nodule in their thryoid glands and planned to get biopsy and analyse the interaction between the data acquired and nodule. The demographyc data (age, sex, profession,), clinical findings, thryoid function tests, routine ultrasonography, scintigraphy data of cases were recorded. After performing fine needle aspiration biopsy, IGF-1 and IGFBP-3 levels were tested in serum and aspiration material by ELISA method. Clinical and laboratory data were compared with pathology results. In our research, IGF-1 levels in serum were found significantly higher (p=<0,01). Similarly, serum IGFBP-3 levels were found significantly higher then inside of nodule (p=<0,01). A positive correlation between serum level of IGF-1 and inside of nodule level of IGF-1 were observed (p=<0,01, r=0,42). Serum level of IGF-1 of women patients were found significantly higher then men (p=0,028). The malignity ratio inside of all case were %3,75, and inside of patients operated patients were %23. Inside of nodule levels of IGF-1 and IGFBP-3 of cases with multinodules were higher than cases with single nodule (p=0,043). A positive correlation between the size of nodule and serum levels of IGFBP-3 was detected (p=0,042, r=0,23). These findings indicates that IGF-1 and IGFBP-3 are effective at pathogenesis of nodular goiter. Key words: Nodular goiter, IGF-1, IGFBP-3