Granados-García Martín, Cortés-Flores Ana Olivia, del Carmen González-Ramírez Imelda, Cano-Valdez Ana María, Flores-Hernández Lorena, Aguilar-Ponce José Luis
Departamento de Tumores de Cabeza y Cuello, Instituto Nacional de Cancerología, Secretaría de Salud, México, D. F., Mexico.
Cir Cir. 2010 Nov-Dec;78(6):473-8.
Thyroid cancer presents as nodules. Thyroid nodules are frequent, but only 5-30% are malignant. Fine needle aspiration biopsy (FNAB) is useful for initial evaluation; nevertheless, malignancy is uncertain when follicular neoplasm is reported. Some factors can be associated with malignancy. Therefore, we analyzed our follicular neoplasms in order to identify those factors associated with a higher risk of malignancy.
We analyzed the clinical files of consecutive patients with cytological diagnoses of follicular neoplasm.
From 1,005 cases of thyroid nodules, 121 were follicular neoplasms according to cytology. Of these, 75 were surgically treated. Definitive report showed 45 benign (60%) and 30 malignant (40%) cases. Benign cases included 29 goiters, 11 follicular adenomas, and 5 cases of thyroiditis. Malignant cases were comprised of 12 papillary carcinomas, 4 follicular carcinomas, 3 papillary carcinomas-follicular variant, 1 lymphoma, 1 teratoma, 5 medullary carcinomas, 2 insular carcinomas, 1 anaplastic carcinoma and 1 metastatic breast carcinoma. Tumor size of benign lesions was 3.43 ± 2.04 cm, and 4.67 ± 2.78 (p = 0.049) for malignant lesions. Age was 46.95 ± 15.39 years for benign lesions and 48.67 ± 17.28 for malignant lesions (p = 0.66). Fifty percent of males showed malignancy vs. 37.7% of females (p < 0.005).
Our results suggest that size and gender, but not age, are associated with cytological pattern. Ultrasonographic characteristics may be useful discriminating patients with a higher risk of malignancy. FNAB is a useful tool for initial evaluation of thyroid nodules, but clinical evaluation can enhance predictive value.
甲状腺癌表现为结节。甲状腺结节很常见，但只有5% - 30%是恶性的。细针穿刺活检（FNAB）对初步评估有用；然而，当报告为滤泡性肿瘤时，恶性程度尚不确定。一些因素可能与恶性肿瘤有关。因此，我们分析了我们的滤泡性肿瘤，以确定那些与较高恶性风险相关的因素。
我们分析了连续的经细胞学诊断为滤泡性肿瘤患者的临床档案。
在1005例甲状腺结节病例中，根据细胞学检查有121例为滤泡性肿瘤。其中75例接受了手术治疗。最终报告显示45例为良性（60%），30例为恶性（40%）。良性病例包括29例甲状腺肿、11例滤泡性腺瘤和5例甲状腺炎。恶性病例包括12例乳头状癌、4例滤泡癌、3例乳头状癌滤泡变异型、1例淋巴瘤、1例畸胎瘤、5例髓样癌、2例岛状癌、1例未分化癌和1例转移性乳腺癌。良性病变的肿瘤大小为3.43±2.04厘米，恶性病变为4.67±2.78厘米（p = 0.049）。良性病变患者的年龄为46.95±15.39岁，恶性病变患者为48.67±17.28岁（p = 0.66）。男性中有50%显示为恶性，女性为37.7%（p < 0.005）。
我们的结果表明，大小和性别而非年龄与细胞学模式有关。超声特征可能有助于鉴别恶性风险较高的患者。FNAB是甲状腺结节初步评估的有用工具，但临床评估可提高预测价值。
