甲状腺结节的临床分析

Clinical analysis of thyroid nodules

目的分析甲状腺结节的流行病学特点,评估现有方法对甲状腺良、恶性结节鉴别诊断的临床应用价值。方法对1 474例接受手术治疗的甲状腺结节患者资料进行回顾性分析,总结超声、术中冰冻和术后石蜡病理诊断的相关性,分析现有方法的临床价值。结果①1 474例患者中男286例,女1 188例。良性结节占77.40%,恶性者占22.60%;男性患者结节的恶性率高于女性患者(28.3%vs 21.3%,P<0.05);②单、多发结节的甲状腺癌发生率分别为33.1%和27.6%,两者间差异无统计学意义(P=0.287)。结节边缘、内部结构、回声类型、内部微钙化、血流分布、颈淋巴结等超声特征在甲状腺良、恶性结节组的分布有统计学差异(P<0.001);而周边缺乏声晕、内部粗钙化在良、恶性结节中的差异无统计学意义(P均>0.05);③冰冻切片确诊率为96.0%,诊断甲状腺癌的敏感性为91.9%,假阴性率为0.5%。石蜡切片共发现微小癌67例,有26例发生了淋巴结转移,转移率为38.8%。结论甲状腺结节以女性高发,但男性恶性率高。超声检查有助于鉴别甲状腺结节的良恶性。术中冰冻检查对于明确甲状腺结节的良、恶性和术式的选择具有关键性作用,是一种较可靠的检查手段。

Objective To analyze the epidemiological characteristics of thyroid nodules and to evaluate the value of the present methods for diagnosing thyroid nodules.Method A retrospective study of 1 474 patients who had undergone surgery for thyroid nodules was made.Results ① There were 286 males and 1 188 females. 1 141(77.40%) patients were diagnosed with benign nodules and 333(22.60%) malignant nodules.The malignant rate was higher in males than in females(28.3% vs 21.3%,P<0.05).② The prevalence of thyroid cancer...