Cusick E L, Krukowski Z H, MacIntosh C A, Matheson N A
Department of Surgery, University of Aberdeen.
BMJ. 1991 Jul 6;303(6793):20-2. doi: 10.1136/bmj.303.6793.20.
To determine the risk of neoplasia and malignancy in "dominant" thyroid swellings.
Prospective analysis during six years.
Thyroid clinic serving the Grampian region.
574 consecutive patients presenting with a discrete thyroid swelling, of whom 179 (31%) were classified clinically as having a dominant area of enlargement within a multinodular gland.
After clinical and cytological assessment 77 dominant swellings were excised. Of the excised swellings, 45 were non-neoplastic and 32 neoplastic, including 11 malignant lesions. The minimum incidence of neoplasia and malignancy in all 179 dominant swellings was therefore 18% and 6% respectively.
Dominant thyroid swellings should be regarded with greater clinical suspicion than has been traditional.
确定“优势性”甲状腺肿大发生肿瘤和恶性病变的风险。
为期六年的前瞻性分析。
服务于格兰扁地区的甲状腺诊所。
574例连续出现孤立性甲状腺肿大的患者，其中179例（31%）临床分类为多结节性腺体中有一个优势性肿大区域。
经过临床和细胞学评估后，77个优势性肿大被切除。在切除的肿大中，45个为非肿瘤性，32个为肿瘤性，其中包括11个恶性病变。因此，在所有179个优势性肿大中，肿瘤和恶性病变的最低发生率分别为18%和6%。
相对于传统认识，优势性甲状腺肿大应受到更大的临床怀疑。
