摘要
目的分析甲状腺微小结节患者的临床病理特征,提高对甲状腺微小结节的诊治水平,以期及时发现甲状腺微小癌。方法选取2011—2013年在新疆医科大学第五附属医院经超声检查发现的甲状腺影像报告和数据系统(TI-RADS)分级标准诊断为3级或4a级的甲状腺微小结节患者108例。对患者进行门诊和电话随访,随访至2015年9月,以随访结束时患者的病情作为统计分析的终点事件,进展为甲状腺微小癌或甲状腺微小良性结节。记录患者性别、年龄、首次超声发现时是否合并其他甲状腺疾病、结节数目、是否为多中心肿瘤、TI-RADS分级、是否规律服用抑制促甲状腺激素(TSH)药物情况,分析其与甲状腺微小癌的相关性。结果 23例患者在随访过程中提示出现疾病进展,进行手术治疗,术后病理诊断为甲状腺微小癌。甲状腺微小良性结节和甲状腺微小癌患者性别、年龄、结节数目、是否为多中心肿瘤、TI-RADS分级比较,差异均有统计学意义(P<0.05);两者是否合并其他甲状腺疾病、是否规律服用抑制TSH药物比较,差异均无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,男性、多发结节、多中心肿瘤、TI-RADS分级为4a级是甲状腺微小癌的危险因素(P<0.05)。结论男性、多发结节、多中心肿瘤、TI-RADS分级为4a级等特征与甲状腺微小癌密切相关,存在以上高危因素的甲状腺微小结节患者应考虑积极手术治疗。
Objective To analyze the clinical pathological characteristics of micro thyroid nodules in order to improve the diagnosis and treatment, and to timely detect thyroid microcarcinoma （TMC） . Methods A retrospective analysis of 108 patients with thyroid nodules who underwent ultrasound examination from the Fifth Affiliated Hospital of Xinjiang Medical University from 2011 to 2013 and were diagnosed as grade 3 or 4a according to TI - RADS grading standards. After clinic and phone call follow - up till September 2015, disease conditions of patients at the end of follow - up were taken as the outcome events statistical analysis, developing to TMC or benign micro thyroid nodule. The following details were recorded： gender, age, if combined with other thyroid diseases when discovered firstly through ultrasound, numbers of nodule, if it was muhicenter tumor, TI - RADS grading and if taking TSH regularly, analyzing its relevance to TMC. Results There were disease progression for 23 cases during follow- up and they were diagnosed as TMC after surgery. Differences regarding gender, age, number of nodule, if it was multieenter tumor and TI - RADS grading between TMC and benign thyroid micro nodule were statistical significance （ P 〈 0. 05 ） ; differences regarding if combined with other thyroid diseases and if taking TSH regularly between themwere not statistical significance （ P 〉 0. 05 ） . Multivariste Logistic regression analysis showed that male, muhiple nodules, muhicenter tumor and 4a grade according to TI - RADS grading were risk factors for TMC. Conclusion Male, multiple nodules, multicenter tumor and 4a grade according to TI - RADS grading are closely related to TMC. High risk factors patients with micro thyroid nodules should be treated with active operation.
出处
《中国全科医学》
CAS
CSCD
北大核心
2016年第24期2880-2883,共4页
Chinese General Practice
