Shi C, Li S, Shi T, Liu B, Ding C, Qin H
Fourth Department of Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
J Int Med Res. 2012;40(1):350-7. doi: 10.1177/147323001204000136.
This study investigated the detection of thyroid nodule calcifications on ultrasound and their relationship to thyroid carcinoma.
Microcalcifications (≤2 mm) and macro calcifications (>2 mm) on preoperative ultrasound examination of thyroid and lymph nodes were compared with postoperative pathological diagnoses in 4186 patients undergoing thyroid surgery.
Higher incidences of micro- and macrocalcifications were found in patients with thyroid carcinoma than in those with benign disease. The incidence of malignant disease was significantly higher in patients with microcalcifications than those with macrocalcifications, suggesting that the presence of microcalcifications is a better predictor of malignant thyroid carcinoma than other calcification types. The specificity of microcalcifications for a diagnosis of malignant thyroid carcinoma was 96.5%. Microcalcifications were significantly more frequent in patients aged≤45 years, but there was no difference between genders. The incidence of malignancy was significantly higher in patients with single nodule calcifications than in those with multiple nodule calcifications. Lymph node calcifications were seen in 12 patients, all of whom had papillary carcinoma.
Thyroid microcalcifications are strongly associated with thyroid carcinoma, especially micropapillary carcinoma. When cervical lymph node calcification is present, immediate surgery is required.
本研究调查了甲状腺结节钙化在超声检查中的检出情况及其与甲状腺癌的关系。
对4186例接受甲状腺手术的患者术前甲状腺及淋巴结超声检查中的微钙化（≤2 mm）和宏钙化（>2 mm）与术后病理诊断结果进行比较。
甲状腺癌患者中微钙化和宏钙化的发生率高于良性疾病患者。微钙化患者的恶性疾病发生率显著高于宏钙化患者，这表明微钙化的存在比其他钙化类型更能预测甲状腺癌的恶性程度。微钙化诊断甲状腺癌的特异性为96.5%。微钙化在年龄≤45岁的患者中更为常见，但性别之间无差异。单结节钙化患者的恶性发生率显著高于多结节钙化患者。12例患者出现淋巴结钙化，所有患者均为乳头状癌。
甲状腺微钙化与甲状腺癌密切相关，尤其是微小乳头状癌。当出现颈部淋巴结钙化时，需要立即进行手术。
