Costante G, Crocetti U, Schifino E, Ludovico O, Capula C, Nicotera M, Arturi F, Filetti S
Department of Clinical and Experimental Medicine, University of Catanzaro, Catanzaro, Italy.
J Endocrinol Invest. 2004 Jan;27(1):31-6. doi: 10.1007/BF03350907.
Benign thyroid nodules represent a very common disorder, the management of which is still controversial. The aim of the present work was to evaluate by ultrasound examination the volume changes of thyroid nodules in post-menopausal women presenting single palpable nodular goiter of recent onset (less than 6 months from diagnosis). Forty-three patients received L-T4-treatment, 38 represented the no-treatment group. Long-term follow up (3 and 5 yr) did not show any significant change in the mean volume nodule in these patients. In the no-treatment group, the mean nodule volumes were stable over time from baseline to 5 yr. No significant difference was observed at any follow-up evaluation between thyroid hormone treated and untreated patients. After 1 yr of treatment, a significant decrease (p = 0.0275) in mean nodule volume occurred only for nodules with a baseline volume lower than 1.5 ml. The frequency of clinically relevant nodule size variation showed a more frequent decrease (13.9%) at 1 yr in the L-T4 group, as compared to the no-treatment group (2.6%), while the proportion of increased volume at 1 yr was higher in the untreated than in the L-T4 group (5.3% vs 2.3%). This inverse relationship between the 2 groups was not statistically significant (p = 0.076). In conclusion, an arrest in the growth of benign thyroid nodules occurs in the majority of women after menopause. Only a very limited number of these patients may benefit from thyroid hormone suppressive treatment.
良性甲状腺结节是一种非常常见的疾病，其治疗方法仍存在争议。本研究的目的是通过超声检查评估绝经后妇女近期出现的单发可触及结节性甲状腺肿（诊断后不到6个月）中甲状腺结节的体积变化。43例患者接受左甲状腺素（L-T4）治疗，38例为未治疗组。长期随访（3年和5年）显示这些患者的平均结节体积没有任何显著变化。在未治疗组中，从基线到5年，平均结节体积随时间保持稳定。在任何随访评估中，甲状腺激素治疗组和未治疗组之间均未观察到显著差异。治疗1年后，仅基线体积小于1.5 ml的结节平均体积出现显著下降（p = 0.0275）。与未治疗组（2.6%）相比，L-T4组在1年时临床相关结节大小变化的频率显示出更频繁的减小（13.9%），而未治疗组1年时体积增加的比例高于L-T4组（5.3%对2.3%）。两组之间的这种反比关系无统计学意义（p = 0.076）。总之，大多数绝经后女性的良性甲状腺结节生长会停止。这些患者中只有极少数可能从甲状腺激素抑制治疗中获益。
