Sippel Rebecca S, Elaraj Dina M, Khanafshar Elham, Kebebew Electron, Duh Quan-Yang, Clark Orlo H
Department of Surgery, University of California San Francisco, and the UCSF Comprehensive Cancer Center at Mount Zion, San Francisco, CA 94143-1674, USA.
Surgery. 2007 Dec;142(6):851-7; discussion 857.e1-2. doi: 10.1016/j.surg.2007.08.011. Epub 2007 Oct 26.
Follicular neoplasms of the thyroid are associated with an approximately 20% risk of malignancy. We sought to determine whether the presence of additional thyroid nodules on preoperative ultrasound decreased the risk of malignancy in a patient with a follicular neoplasm.
Between January 2000 and November 2006, 325 patients underwent thyroidectomy with a fine needle aspiration diagnosis of either follicular neoplasm, Hürthle cell neoplasm, or indeterminate (not including suspicious for papillary thyroid cancer). Records were reviewed retrospectively and statistical analysis was performed using SPSS (SPSS Corporation, Chicago, Ill).
The rate of malignancy in our patient population was 20% (23% in follicular neoplasm, 19% in Hürthle cell neoplasm, 9% in indeterminate). Overall, 57% of patients had multiple thyroid nodules on preoperative ultrasound. The risk of malignancy was lower in patients with greater than or equal to 1 additional nodule in comparison with those with a solitary nodule (16.6% vs 28.0%, P = .02). The risk of malignancy was lowest in those with 1-3 additional nodules in comparison with those with greater than or equal to 4 nodules (14.5% vs 21.7%, P = .04).
The presence of additional thyroid nodules on preoperative ultrasound is associated with a lower risk of malignancy in a patient with a follicular neoplasm.
甲状腺滤泡性肿瘤的恶性风险约为20%。我们试图确定术前超声检查发现额外的甲状腺结节是否会降低滤泡性肿瘤患者的恶性风险。
2000年1月至2006年11月期间，325例患者接受了甲状腺切除术，细针穿刺活检诊断为滤泡性肿瘤、许特莱细胞肿瘤或不确定（不包括可疑甲状腺乳头状癌）。对记录进行回顾性审查，并使用SPSS（SPSS公司，伊利诺伊州芝加哥）进行统计分析。
我们患者群体中的恶性率为20%（滤泡性肿瘤为23%，许特莱细胞肿瘤为19%，不确定为9%）。总体而言，57%的患者术前超声检查发现有多个甲状腺结节。与单发结节患者相比，有一个及以上额外结节的患者恶性风险较低（16.6%对28.0%，P = 0.02）。与有4个及以上额外结节的患者相比，有1 - 3个额外结节的患者恶性风险最低（14.5%对21.7%，P = 0.04）。
术前超声检查发现额外的甲状腺结节与滤泡性肿瘤患者较低的恶性风险相关。
