Dralle H
Klinik für Allgemein-, Viszeral- und Gefässchirurgie, Universitätsklinikum Halle (Saale).
Chirurg. 2007 Aug;78(8):677-86. doi: 10.1007/s00104-007-1376-7.
Thyroid incidentalomas have been found in about 20% of cases screened by neck ultrasound, and asymptomatic thyroid cancer is detected in about 10% of autopsies. The incidence of clinically treated thyroid cancer in Germany is increasing without an increase in cancer-specific mortality. Presently the incidence is about 4500 cases per year (7.3/100,000, 3000 females). For early detection and treatment of clinical thyroid cancer ultrasonography-guided fine needle aspiration cytology of suspicious nodules therefore is crucial. Thyroid lobectomy is the treatment of choice for suspicious nodules to lower the risk of morbidity in case of reoperation due to a postoperative diagnosis of cancer. However, subtotal lobectomy may also be justified, especially with nodules in anterior position, because the risk of malignancy is only 3-5%. Frozen selection and/or early final histopathology should be available to avoid two-stage thyroid cancer operations.
在接受颈部超声筛查的病例中，约20%发现有甲状腺偶发瘤，而在约10%的尸检中检测到无症状甲状腺癌。德国临床治疗的甲状腺癌发病率在上升，但癌症特异性死亡率并未增加。目前发病率约为每年4500例（7.3/10万，女性3000例）。因此，对于临床甲状腺癌的早期检测和治疗，超声引导下对可疑结节进行细针穿刺活检至关重要。甲状腺叶切除术是可疑结节的首选治疗方法，以降低术后诊断为癌症而再次手术时的发病风险。然而，次全叶切除术也可能合理，特别是对于位于前部的结节，因为恶性风险仅为3 - 5%。应提供冰冻切片检查和/或早期最终组织病理学检查，以避免进行二期甲状腺癌手术。
