Ogawa Toshihisa, Kammori Makoto, Tsuji Ei-Ichi, Kanauchi Hajime, Kurabayashi Rie, Terada Kotoe, Mimura Yoshikazu, Kaminishi Michio
Department of Endocrine Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Thyroid. 2007 Jan;17(1):59-62. doi: 10.1089/thy.2006.0182.
In parathyroidectomy, it has been recognized that a shift to a minimally invasive procedure may be accompanied by a possibility of missing thyroid pathology. However, only a few findings concerning preoperative thyroid evaluation have been reported. We investigated the prevalence of concomitant thyroid pathology by preoperative neck ultrasonography (US) in patients with primary hyperparathyroidism. There were 85 patients (66 women, 19 men; mean age 57 years) in the study group. The mean preoperative calcium level was 11.2mg/dL, and the mean intact parathyroid hormone level was 206 pg/mL. All patients underwent neck US following fine-needle aspiration biopsy (FNAB). Of the 85 patients, 21 (24.7%) had thyroid nodules. Among 21 patients with thyroid nodules, 9 (10.6%) had malignant thyroid tumors, while 12 (14.1%) patients had benign thyroid nodules including multinodular goiter. Of the 9 patients with malignant thyroid nodules, 4 had papillary carcinomas with lymph node metastases. The prevalence of thyroid disease associated with hyperparathyroidism is high, and evaluation of the thyroid pathology by US enables the shift from bilateral neck exploration to the minimally invasive parathyroid surgery.
在甲状旁腺切除术中，人们已经认识到转向微创手术可能伴随着遗漏甲状腺病变的可能性。然而，关于术前甲状腺评估的相关研究结果报道较少。我们通过术前颈部超声检查（US）对原发性甲状旁腺功能亢进患者合并甲状腺病变的患病率进行了调查。研究组有85例患者（66例女性，19例男性；平均年龄57岁）。术前血钙平均水平为11.2mg/dL，甲状旁腺激素平均水平为206pg/mL。所有患者在细针穿刺活检（FNAB）后均接受了颈部超声检查。85例患者中，21例（24.7%）有甲状腺结节。在21例有甲状腺结节的患者中，9例（10.6%）患有甲状腺恶性肿瘤，而12例（14.1%）患者有包括结节性甲状腺肿在内的良性甲状腺结节。在9例甲状腺恶性结节患者中，4例为伴有淋巴结转移的乳头状癌。与甲状旁腺功能亢进相关的甲状腺疾病患病率较高，通过超声评估甲状腺病变有助于从双侧颈部探查转向微创甲状旁腺手术。
