儿童甲状腺结节：单机构经验
Thyroid nodules in childhood: a single institute experience.
作者信息
Mirshemirani Alireza, Roshanzamir Fatolah, Tabari Ahmad Khaleghnejad, Ghorobi Javad, Salehpoor Shadab, Gorji Fatemeh Abdollah
机构信息
Department of Pediatric Surgery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
出版信息
Iran J Pediatr. 2010 Mar;20(1):91-6.
OBJECTIVE
Thyroid nodules are rare in children. Multiple diagnostic modalities are used to evaluate the thyroid mass. The aim of this study was to determine results of management of thyroid nodules in children with special attention to the role of fine needle aspiration biopsy (FNAB) in diagnosis.
METHODS
Thirty-two children who underwent surgery for thyroid nodules in Mofid Children's Hospital within 10 years (1996 to 2005) were retrospectively studied. From clinical records we obtained data about demographic characteristics, clinical manifestations, ultrasonography (USG) findings, and FNAB results, pathological reports, surgical therapy and complications. Data was analyzed statistically for association with thyroid cancer.
FINDINGS
Twenty-five patients (78.1%) were girls, and 7 (21.9%) boys. Mean age was 10.9 (range 8 to 14) years. 24 (75%) patients had benign and 8 (25%) malignant tumors. 18 (56.25%) nodules were located in the right lobe. Statistical analysis revealed sensitivity, specificity, accuracy, and positive and negative predictive values as follows: 80%, 65%, 63%, 25%, and 86% for USG; 35%, 41%, 40%, 18%, and 66% for RNS; 91%, 94%, 90%, 74%, and 96% for FNAB respectively.
CONCLUSION
Clinical judgment as determined by serial physical findings with USG continues to be the most important factor in the management of thyroid nodules in children. FNAB is the most accurate method of investigation and its accuracy is improved by USG guidance.
目的
甲状腺结节在儿童中较为罕见。多种诊断方式用于评估甲状腺肿物。本研究的目的是确定儿童甲状腺结节的治疗结果，特别关注细针穿刺活检（FNAB）在诊断中的作用。
方法
回顾性研究了10年间（1996年至2005年）在莫菲德儿童医院接受甲状腺结节手术的32名儿童。从临床记录中，我们获取了有关人口统计学特征、临床表现、超声检查（USG）结果、FNAB结果、病理报告、手术治疗及并发症的数据。对数据进行统计学分析以确定与甲状腺癌的相关性。
结果
25名患者（78.1%）为女孩，7名（21.9%）为男孩。平均年龄为10.9岁（范围8至14岁）。24名（75%）患者患有良性肿瘤，8名（25%）患有恶性肿瘤。18个（56.25%）结节位于右叶。统计分析显示，USG的敏感性、特异性、准确性以及阳性和阴性预测值分别为：80%、65%、63%、25%和86%；RNS的分别为：35%、41%、40%、18%和66%；FNAB的分别为：91%、94%、90%、74%和96%。
结论
由连续体格检查及USG所确定的临床判断仍然是儿童甲状腺结节治疗中最重要的因素。FNAB是最准确的检查方法，在USG引导下其准确性得以提高。
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