中华临床医师杂志(电子版) 2017年2月,11卷4期

临床论著

甲状腺结节973例超声与病理特点

宋立稳 柳林 卢洪文 刘长山

261041 山东省,潍坊市人民医院内分泌科
柳林,Email: liulin_sd@sina.com

摘要:目的 分析经过手术治疗的973例甲状腺结节患者的超声及病理特点,为甲状腺结节的诊断及治疗提供帮助,避免过度诊疗。方法 收集潍坊市人民医院2014年1月至2015年12月经手术治疗的973例甲状腺结节患者的一般临床资料、术前超声检查结果及术后病理诊断结果,并对其进行回顾性分析。结果 973例甲状腺结节患者中男性226例,女性747例,男女比例1∶3.31;手术证实的甲状腺良性结节873例,占全部甲状腺结节的比例为89.72%,其中男性198例,女性675例,平均年龄49.92岁;甲状腺恶性结节100例,占全部甲状腺结节的比例为10.28%,其中男性28例,女性72例,平均年龄46.48岁。良性结节与恶性结节之比为8.73∶1,其中良性结节以结节性甲状腺肿(415例)及甲状腺(囊)腺瘤(438例)为主,恶性结节以甲状腺乳头状癌为主(98例)。甲状腺功能比较,甲状腺恶性结节患者血清促甲状腺激素(TSH)水平有增高趋势。同时将术后病理诊断与术前超声诊断进行比较,因片面地注重甲状腺结节的某一声像特征引起误诊病例共8例。结论 甲状腺结节患者多见于中年女性,以良性结节为主。恶性结节多见于中青年女性,甲状腺恶性结节患者TSH水平有增高趋势。术前对甲状腺结节的超声进行全面诊断有利于减少误诊率,可以更合理地选择治疗方式,避免过度诊疗。

关键词:甲状腺结节; 超声检查; 病理学,临床[DOI:10.3877/cma.j.issn.1674-0785.2017.04.010

卫生部卫生行业科研专项项目(201202008);山东省医药卫生科技发展项目(2015WSA07029)

Analysis on the ultrasound and pathologic feature of 973 cases patients with thyroid nodules

Song Liwen, Liu Lin, Lu Hongwen, Liu Changshan.

Department of Endocrinology, Weifang People's Hospital, Weifang 261041, China
Liu Lin, Email: liulin_sd@sina.com

Abstract: Objective To analyze the ultrasound and pathologic feature of 973 patients with thyroid nodules who received operation, in order to provide help for the clinical diagnosis and treatment of thyroid nodules, avoid excessive diagnosis and treatment. Methods Analyzed the clinical data, ultrasound findings and pathologic results of 973 patiens of thyroid nodule who received operation from Jan. 2014 to Dec. 2015. Results According to this data, 226 male cases and 747 female cases were included, the ratio of male to female was 1∶3.31; 873 cases were benign nodules, account for 89.72% of all the thyroid nodules, including 198 male and 675 female, with an average age of 49.92 years; 100 cases were malignancy nodules, accounted for 10.28% of all the thyroid nodules, including 28 male and 72 female, with an average age of 46.48 years. The ratio of benign to malignancy nodules was 8.73∶1, nodular goiter and adenoma of thyroid played a major role among benign nodules, papillary thyroid cancer played a major role among malignancy nodules. Compared the level of thyroid hormone, the level of TSH in malignancy nodules showed an increasing trend, analyzed the difference of pathologic diagnosis and ultrasound diagnosis, basing emphasis on a certain feature of thyroid tubercle leaded to 8 cases of misdiagnosis. Conclusion Patients with thyroid nodule in middle aged female, and benign nodules plays a major role. Malignancy nodules in young and middle-aged female, and its TSH level shows a trend of increase. Comprehensive diagnosis in ultrasound before operation can reduce the loss of misdiagnosis rate, choose a more reasonable treatment, avoid excessive diagnosis and treatment.

Keywords:Thyroid nodule; Ultrasonography; Pathology, clinical

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(编辑:吴莹 收稿日期:2016-09-22)