结节性甲状腺肿伴钙化与甲状腺癌关系的探讨
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石臣磊

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The correlation between calcified nodular goiter and thyroid carcinoma
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    目的:探讨结节性甲状腺肿伴钙化与甲状腺癌的关系。方法:回顾性分析5年间经术前高频超声诊断为结节性甲状腺肿伴钙化患者1 024例的临床资料,其中恶性结节544例(53.1%)。结果: 恶性钙化结节在男、女之间比例分别为58.3%和52.5%(P>0.05 ) ;在≥45岁和<45岁间比例分别为39.2%和69.3%(P<0.05);在单发结节和多发结节组间比例为69%和49.2%(P<0.05);在微小钙化和非微小钙化间分别为79.1%和41.2%(P<0.01)。结论:超声探查到的钙化病灶中半数以上是恶性病变,一旦发现结节性甲状腺肿合并钙化,则应密切考虑恶性可能。微小钙化对预测乳头状癌有高度特异性。当结节性甲状腺肿出现钙化或钙化出现在局部淋巴结时,应立即进行手术治疗。

    Abstract:

    Objective:To investigate the relation between calcification of nodular goiter and thyroid carcinoma.Methods :The clinical data of 1 024 cases of calcified nodular goiter, of which 544 cases (53.1%) were malignant, who were seen in our hospital during the past five years and were examined by highresolution ultrasonography preoperatively, were retrospectively reviewed.Results:There was no difference in the percentage of malignant calcified nodules between the male and female groups (58.3% and 52.5%, respectively;P>0.05 ).There was a significant difference in the percentage of malignant calcified nodules between the patients of 45 years and older with those younger than 45 years (39.2% and 69.3%,respectively;P<0.05).There was a significant difference in the percentage of malignant calcified nodules between the patients with solitary and multiple nodules (69% and 49.2%, respectively;P<0.05).Moreover, there was a significant difference in the percentage of malignant calcified nodules between the group with microcalcification and the group with nonmicrocalcification (79.1% and 41.2%, respectively;P<0.01).Conclusions:More than half the number of calcified thyroid nodules detected by ultrasonography have malignant pathological change, and once it is discovered that the nodular goiter has calcification,one should highly consider the possibility of malignancy. Microcalcification is a highly specific sign that predicts thyroid papillary carcinoma.When calcification appears in thyroid nodules or in regional lymph nodes, immediate surgery is required.

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秦华东, 石臣磊, 石铁锋, 孙宇.结节性甲状腺肿伴钙化与甲状腺癌关系的探讨[J].中国普通外科杂志,2008,17(11):2-105.
DOI:10.7659/j. issn.1005-6947.2008.11.002

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  • 在线发布日期: 2008-11-25