Mitra Sujata, Jha Mukesh, Gandhi Km
Department of Nuclear Medicine, Tata Main Hospital, Jamshedpur - 831 001, India.
Indian J Nucl Med. 2010 Apr;25(2):57-61. doi: 10.4103/0972-3919.72688.
Nodular thyroid disease is a common endocrine problem. Most thyroid nodules are benign hyperplastic lesions, but 5-20% may be a true neoplasm. It is important to differentiate a benign from a malignant nodule early as the approach to treatment in the two is radically different. Early institution of medical management in a benign nodule may obviate the need for surgery.
The present work aims to study the efficacy of thyroxine suppression in the management of benign thyroid nodules.
A prospective study on patients presenting with thyroid nodule was undertaken. The diagnostic work-up included a clinical evaluation, thyroid function tests, thyroid scintigraphy and fine needle aspiration cytology. Based on the investigations, patients were segregated in Group A (toxic nodular goiter), Group B (benign euthyroid nodule) and Group C (malignant nodule). Group A patients were managed with antithyroid drugs and radioiodine and Group C patients were managed surgically. Group B patients were put on thyroxine suppression. Patients who failed to show reduction in size of the nodule at 18 months were treated surgically.
The response rate of benign euthyroid nodule to thyroxine suppression was 76% in the present study.
结节性甲状腺疾病是一种常见的内分泌问题。大多数甲状腺结节是良性增生性病变，但5%-20%可能是真正的肿瘤。尽早区分良性结节和恶性结节很重要，因为两者的治疗方法截然不同。对良性结节尽早进行医学管理可能无需进行手术。
本研究旨在探讨甲状腺素抑制治疗在良性甲状腺结节管理中的疗效。
对出现甲状腺结节的患者进行了一项前瞻性研究。诊断性检查包括临床评估、甲状腺功能测试、甲状腺闪烁扫描和细针穿刺细胞学检查。根据检查结果，患者被分为A组（毒性结节性甲状腺肿）、B组（良性甲状腺功能正常结节）和C组（恶性结节）。A组患者采用抗甲状腺药物和放射性碘治疗，C组患者采用手术治疗。B组患者接受甲状腺素抑制治疗。在18个月时结节大小未缩小的患者接受手术治疗。
在本研究中，良性甲状腺功能正常结节对甲状腺素抑制治疗的反应率为76%。
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