双侧分化型甲状腺癌的特征因素研究

Pathoclinical characteristics of bilateral well-differentiated thyroid carcinoma

目的统计全甲状腺切除或近全切除术后双侧分化型甲状腺癌发现率，研究其特征因素。方法回顾性分析121例全甲状腺切除或近全切除病例资料，对单侧甲状腺癌组和双侧甲状腺癌组的13项观察指标进行单因素和Logistic回归分析。结果全甲状腺切除或近全切除术后病理证明约33．06％患者为双侧分化型甲状腺癌。Logistic回归分析提示年龄〈50岁、超声发现双叶结节及第一结节≥2cm是双侧癌的独立危险因素（P〈0．05）。结论在术前各项检查提示甲状腺第一结节为恶性肿瘤的前提下，如患者年龄〈50岁、超声发现双叶结节且第一结节〉2cm，应注意考虑是否有双侧甲状腺癌存在的可能。

Objective To calculate the incidence of pathology-proved bilateral well-differentiated thyroid carcinoma （BWDTC） in patients undergoing total or near total thyroidectomy. Methods Clinical data were retrospectively reviewed in 121 patients who underwent total or near total thyroidectomy. Thirteen indexes selected from both the unilateral thyroid carcinoma group and the bilateral thyroid carcinoma group were adopted to undergo a univariate analysis and Logistic regression analysis. Results BWDTC was found in 33.06% patients after total or near total thyroidectomy. Logistic regression analysis showed that patient＇s age 〈 50, bilateral nodules based on ultrasound and the diameter of the first nodule 〉 2 cm were independent risk factors for BWDTC （ P 〈 0. 05 ）. Conclusions In the premise of a malignant first nodule found in the preoperative examinations, BWDTC should be highly suspected if the patient is under 50 years old, has bilateral nodules found by preoperative ultrasound and the diameter of the first malignant nodule is over 2 cm