甲状腺结节钙化的临床价值

Clinical significance of thyroid nodule calcification

目的探讨甲状腺结节钙化在临床诊治中的意义。方法回顾性分析2002年6月至2003年8月中山大学附属第一医院收治的543例甲状腺结节病人的临床、B超扫描和病理资料。543例甲状腺结节中良性病变473例(87·1%),恶性病变70例(12·9%)。结果121例甲状腺结节有钙化,占22·3%,其中恶性肿物的钙化发生率(52·9%)明显高于良性甲状腺肿物(17·8%,P<0·05)。单发结节、伴有颈部淋巴结肿大甲状腺肿物为恶性的可能性大(P<0·05)。结论B超检查发现甲状腺结节钙化,并有结节边界模糊、形态不规则、低回声和血流信号丰富时,宜采用积极的治疗方法。

Objective To evaluate the significance of sonographically detected thyroid nodule calcification in the diagnosis of thyroid cancer. Methods Retrospective analyze was carried out on the features of clinical finding and ultrasonic characteristics as well as pathological results of 543 patients with thyroid nodules admitted between June 2002 and August 2003 in the First Affiliated Hospital of Sun Yat-sen University. Results In 543 cases, histopathologic examination showed benign thyroid nodules was in 473 cases （87.1%） and malignancy in 70 cases （12.9%）, sonographical thyroid calcification was found in 121 cases （22.3%）. The incidence of calcification in malignant thyroid nodule was higher than in benign thyroid nodule （52.9% vs 17.8%, P〈0.05）. Solitary thyroid nodule and nodule with enlargement of cervical lymph nodes had a higher risk of malignancy （P〈0.05）. Conclusions It is founded by ultrasonography that thyroid calcification, Sunclear and irregular margins, low echo and plenty of blood flow within the thyroid nodule are reliable indication of malignancy. The surgical treatment should be performed actively.