Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
Endocr J. 2013;60(2):155-60. doi: 10.1507/endocrj.ej12-0294. Epub 2012 Oct 6.
Various patterns of calcification have been detected in benign and malignant thyroid nodules on ultrasonography (US). Microcalcification has been found to be highly associated with papillary thyroid carcinoma. However, other patterns of calcification have unclear clinical significance. The aim of this study was to evaluate which pattern of calcification could be predictive of malignancy. A total of 1,431 thyroid nodules of 1,078 patients who received preoperative ultrasound examinations and subsequently underwent thyroidectomy were retrospectively reviewed. The types of calcification were defined as follows: microcalcification, annular-like peripheral calcification, crescent-like peripheral calcification, intranodular coarse calcification, and calcified spot. Of these 1,431 nodules, 1,305 (91.1%) were thyroid carcinomas and 126 (8.9%) were benign nodules. Calcifications were detected in 38.6% (552/1,431) of all nodules. Calcifications were found in 40.2% (524/1,305) of malignant nodules and 22.2% (28/126) of benign nodules. Of the 524 malignant nodules with calcification, microcalcification was the most common pattern, occurring in 42.9% (225/524), and annular type was the least common pattern, occurring in 5.9% (31/524). Among the calcification types, only microcalcification and intranodular had a significant association with malignancy (p = 0.001, 0.035), with OR values of 3.5 (95% CI, 1.6-7.7) and 2.4 (95% CI, 1.1-5.6). Though using the patterns of calcification alone for predicting malignancy had limitation, microcalcification and intranodular calcification were significantly associated with malignancy.
在超声检查中，已发现良性和恶性甲状腺结节存在各种类型的钙化。微钙化与甲状腺乳头状癌高度相关。然而，其他类型的钙化临床意义尚不清楚。本研究旨在评估哪种类型的钙化可以预测恶性肿瘤。回顾性分析了 1078 例接受术前超声检查并随后行甲状腺切除术的 1431 个甲状腺结节。钙化类型定义如下：微钙化、环形周边钙化、新月形周边钙化、结节内粗钙化和钙化点。在这 1431 个结节中，1305 个（91.1%）为甲状腺癌，126 个（8.9%）为良性结节。所有结节中 38.6%（552/1431）发现钙化。恶性结节中 40.2%（524/1305）发现钙化，良性结节中 22.2%（28/126）发现钙化。在 524 个有钙化的恶性结节中，微钙化最常见，占 42.9%（225/524），环形类型最不常见，占 5.9%（31/524）。在钙化类型中，只有微钙化和结节内钙化与恶性肿瘤显著相关（p=0.001，0.035），OR 值分别为 3.5（95%CI，1.6-7.7）和 2.4（95%CI，1.1-5.6）。尽管单独使用钙化模式预测恶性肿瘤存在局限性，但微钙化和结节内钙化与恶性肿瘤显著相关。
