CAJ | 학술논문

甲状腺结节是人群多发疾病，是最常见的甲状腺疾病，随着各种患病影响因素的干预及医学影像学技术的发展和应用，其患病率逐年增加。因其存在恶性结节的可能，所以，应尽早通过病史采集、体格检查和影像学检查等对结节性质和预后进行评估。其中，血清促甲状腺激素和超声检查对评估结节功能、判断结节的良恶性尤为重要。超声引导下的细针穿刺活检是除手术病理外诊断甲状腺恶性程度、选择手术方法的重要依据。但仅根据活检结果仍有部分患者无法排除其恶性结节的诊断。而突变基因检测和分子标记技术与细胞学诊断的联合应用，极大提高了术前诊断的准确性，降低了良性结节的手术率。此外，弹性超声和2-氟-2-脱氧-D-葡萄糖-正电子发射断层成像扫描对判断甲状腺结节性质的作用仍有待进一步研究。部分良性结节可采取积极治疗，包括手术、放射性碘治疗及经皮无水酒精注射等措施，大部分良性甲状腺结节患者除了定期随访外尚不需要特殊干预，但是否应用左甲状腺素抑制治疗仍存在争议。早期发现、积极诊疗对甲状腺结节，尤其是恶性甲状腺结节的预后具有重要意义。
갑상선결절시인군다발질병，시최상견적갑상선질병，수착각충환병영향인소적간예급의학영상학기술적발전화응용，기환병솔축년증가。인기존재악성결절적가능，소이，응진조통과병사채집、체격검사화영상학검사등대결절성질화예후진행평고。기중，혈청촉갑상선격소화초성검사대평고결절공능、판단결절적량악성우위중요。초성인도하적세침천자활검시제수술병리외진단갑상선악성정도、선택수술방법적중요의거。단부근거활검결과잉유부분환자무법배제기악성결절적진단。이돌변기인검측화분자표기기술여세포학진단적연합응용，겁대제고료술전진단적준학성，강저료량성결절적수술솔。차외，탄성초성화2-불-2-탈양-D-포도당-정전자발사단층성상소묘대판단갑상선결절성질적작용잉유대진일보연구。부분량성결절가채취적겁치료，포괄수술、방사성전치료급경피무수주정주사등조시，대부분량성갑상선결절환자제료정기수방외상불수요특수간예，단시부응용좌갑상선소억제치료잉존재쟁의。조기발현、적겁진료대갑상선결절，우기시악성갑상선결절적예후구유중요의의。
Thyroid nodule is a very frequent pathology among common population and the most common thyroid disease. With the various risk factors for thyroid nodule and the increasing development and application of modern medical imaging equipment, the prevalence of thyroid nodule rises up yearly. Because of exists of malignancy possibility, early evaluation of the property and prognosis by history collection, physical examination and medical imaging examinations are very important for patients with thyroid nodule. Both the level of thyroid stimulating hormone and ultrasonographic characteristics of thyroid are significantly important for evaluation of the function and property of thyroid nodule. Fine needle aspirate biopsy guided by ultrasound is one of the most valuable evidences for diagnosis of thyroid cancer and operating methods for thyroidectomy. But there are still some patients with thyroid nodule that can not have an accurate diagnosis by the result of fine needle aspirate biopsy. The combination of mutant gene detection, molecular marker technology and cytological diagnosis significantly improve the accurate of diagnosis before the operation, and it also reduce the surgical resection rate for patients with benign thyroid nodule. In addition, the role of ultrasound elastography and 2-fluoro-2-deoxidation-D-glucose-positron emission tomography image for the property diagnosis of thyroid nodule needs further explore. Some patients with benign thyroid nodule can take an active treatment, including surgical operation, radioactive iodine treatment, percutaneous ethanol injection and so on. And most patients with benign thyroid nodule need no further therapy in addition to follow-up on time. But the controversy of whether the suppression therapy by left thyroid hormone should be given to patients with benign thyroid nodule still exists. Early detection, active diagnosis and treatment for patients with thyroid nodule especially thyroid cancer are of great significance.