CAJ | 학술논문

目的探讨甲状腺结节合并钙化与甲状腺癌的关系及其对甲状腺癌高危人群筛选的临床意义.方法回顾性分析2006年3月至2009年3月行甲状腺手术的1771例患者中甲状腺结节合并不同类型钙化的甲状腺癌发生率.结果本组病例中恶性肿瘤500例,甲状腺癌的钙化发生率为68.4%,良性疾病中的钙化发生率为27.0%,差异有统计学意义(χ2=259.5,P＜0.05).微钙化诊断甲状腺癌的特异性为89.4%,阳性预测值为66.3%,与其在良性疾病中的差异有统计学意义(χ2=368.6,P＜0.01).年龄＜45岁的甲状腺癌发生率为39.2%,≥45岁的甲状腺癌发生率为22.9%,差异有统计学意义(χ2=51.12,P＜0.05).单发结节的甲状腺癌发生率为31.7%,多发结节为26.4%,两者差异有统计学意义(χ2=4.766,P＜0.05).B超显示淋巴结肿大最终证实为甲状腺癌转移的比例为26.8%.结论钙化尤其是微钙化对于诊断甲状腺癌的特异性较高,具有重要的临床意义.甲状腺癌的高危人群包括:甲状腺结节合并微钙化、年龄＜45岁及单发结节.
목적 탐토갑상선결절합병개화여갑상선암적관계급기대갑상선암고위인군사선적림상의의.방법 회고성분석2006년3월지2009년3월행갑상선수술적1771례환자중갑상선결절합병불동류형개화적갑상선암발생솔.결과 본조병례중악성종류500례,갑상선암적개화발생솔위68.4%,량성질병중적개화발생솔위27.0%,차이유통계학의의(χ2=259.5,P＜0.05).미개화진단갑상선암적특이성위89.4%,양성예측치위66.3%,여기재량성질병중적차이유통계학의의(χ2=368.6,P＜0.01).년령＜45세적갑상선암발생솔위39.2%,≥45세적갑상선암발생솔위22.9%,차이유통계학의의(χ2=51.12,P＜0.05).단발결절적갑상선암발생솔위31.7%,다발결절위26.4%,량자차이유통계학의의(χ2=4.766,P＜0.05).B초현시림파결종대최종증실위갑상선암전이적비례위26.8%.결론 개화우기시미개화대우진단갑상선암적특이성교고,구유중요적림상의의.갑상선암적고위인군포괄:갑상선결절합병미개화、년령＜45세급단발결절.
Objective To investigate the relationship between thyroid nodules with calcification and thyroid carcinoma and its significance in the screening of thyroid carcinoma in high risk group.Methods The clinical data of 1771 patient undergoing surgery for thyroid nodules from March, 2006 to March, 2009 in Huashan Hospital, Fudan University were retrospectively analyzed. Results Among 1771 patients, 500 were finally identified as having malignant tumors. Incidence of calcification in thyroid carcinoma was 68. 4%, and that in benign thyroid nodules was 27.0% ( χ2 = 259. 5, P ＜ 0. 05 ). The specificity of microcalcification for the diagnosis of carcinoma was 89. 4%, and its positive predictive value was 66. 3% ( χ2 = 368.6, P ＜ 0. 01 ). The incidence of thyroid carcinoma in patients ＜ 45 years was 39.2%, while that in patients ≥ 45 years was 22.9% ( χ2 = 51.12, P ＜ 0. 05 ). The incidence of carcinoma in patients of single thyroid nodule was 31.7% and that in those with multiple nodules was 26. 4% (χ2 =4. 766,P ＜ 0. 05). Metastasis was pathologically diagnosed in 26. 8% of lymph nodes found by preoperative ultrasonography. Conclusions The specificity of thyroid nodule calcification, especially microcalcification is high for the diagnosis of thyroid carcinoma. High-risk index for carcinoma includes thyroid nodules with microcalcification, ＜ 45 years old and single thyroid nodule.