甲状腺乳头状癌与甲状腺结节钙化的关系探讨

The Correlation between Calcified Thyroid Nodules and Thyroid Papillary Carcinoma

目的:探讨B超下甲状腺结节钙化与甲状腺癌间的关系。方法:收集本院1年间手术前经彩超诊断甲状腺结节有钙化的患者107例,回顾性分析恶性结节在钙化结节中所占比例,以及其在不同性别、年龄组、钙化组之间的差异。结果:在107例钙化结节中恶性有56例,占52.3%;术后病理学证实均为乳头状癌。恶性钙化结节在不同年龄组间(≥45岁和<45岁)比例分别为38.6%、68.0%,差异有显著性(P=0.002);在不同性别之间分别为72.7%、50.0%,差异无显著性(P=0.153);在不同钙化组间(微钙化和粗钙化)分别为78.8%、40.5%,差异有极显著性(P<0.001)。结论:甲状腺结节内钙化灶的检测对诊断甲状腺癌具有重要的临床应用价值,微钙化对诊断甲状腺癌有高度特异性,特别是乳头状癌。

Objective： To investigate the calcification of thyroid nodules detected by ultrasound and its relation with thyroid carcinoma. Methods： One hundred and seven cases of calcified thyroid nodules seen in our hospital during a period of one year were examined by high-resolution colored ultrasonography preoperatively. The percentage of malignancy found in those calcified nodules in different sexes, ages and calcification groups was retrospectively reviewed. Results： Fifty-six cases of calcified nodules were confirmed postoperatively to be thyroid papillary carcinoma by pathology（52.3%）. There was a significant difference in the percentages of malignant calcified nodules between the different age groups （38.6% for patients of 45 and older, 68% for patients younger than 45; P=0.002）. There was no significant difference in the percentage of malignant calcified nodules between the male and female groups （72.7% and 50%, respectively; P=0.153）. However, there was a significant difference in the percentage of malignant calcified nodules between the group with microcalcification and the group with coarse calcification（78.8% and 40.5%, respectively; P〈0.001）. Conclusion： Detection of calcification inside thyroid nodules has a clinical significance in the diagnosis of thyroid carcinoma. Microcalcification is a highly specific sign that predicts thyroid malignancy, especially papillary carcinoma.