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意大利摩德纳地区健康志愿者中甲状腺超声扫描异常的高发生率。

Very high prevalence of ultrasound thyroid scan abnormalities in healthy volunteers in Modena, Italy.

机构信息

Unit and Chair of Endocrinology & Metabolism, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.

出版信息

J Endocrinol Invest. 2013 Oct;36(9):722-8. doi: 10.3275/8931. Epub 2013 Apr 12.

Abstract

BACKGROUND

Italy is characterized by high prevalence of goiter. To date, only limited data about the prevalence of goiter in the Italian adult population are available.

AIM

To investigate the prevalence of thyroid ultrasound abnormalities in adults unaware of any thyroid disease and evaluate the rate of differentiated thyroid cancer (DTC) obtained by this intervention.

METHODS

Ultrasound (US) thyroid scan was performed in adult volunteers recruited by advertisement in Modena, Italy. One hundred and thirty-five women and 66 men (no.= 201), unaware of any thyroid disease (mean age of 46 ± 10.7 yr) underwent their first thyroid US scan.

RESULTS

US thyroid abnormalities were found in 101 subjects (50.3%): 91 nodular goiters (45.2%) and 13 US-thyroiditis (6.5%) associated with positive auto-antibodies in 11 of them. Seventeen subjects (18%) with nodules underwent US-fine needle aspiration biopsy with the following cytological class (C) outcome: 14 patients C2 (82%), 1 patient C3 (6%), 2 patients had C4 (12%), the latter received histological confirmation.

CONCLUSIONS

The prevalence of thyroid abnormalities is very high in subjects unaware of any thyroid disease. DTC was found in 1% of subjects and in 2% of those affected by nodular goiter. Compared to the detection rate of the well-established screening programs for breast (0.45%) and colorectal (0.27%) cancer, the prevalence of DTC seems to be much higher. Thyroid US screening could allow the detection of DTC in asymptomatic subjects and this diagnosis often includes DTC at an advanced stage. Thus, US screening not necessarily results in the over-diagnosis of clinically not relevant thyroid diseases.

摘要

背景

意大利甲状腺肿的患病率很高。迄今为止,仅有有限的数据可用于描述意大利成年人群体中甲状腺肿的患病率。

目的

调查甲状腺超声异常在不了解任何甲状腺疾病的成年人中的发生率,并评估通过这种干预获得的分化型甲状腺癌(DTC)的发生率。

方法

通过在意大利摩德纳的广告招募成年志愿者进行超声(US)甲状腺扫描。135 名女性和 66 名男性(共 201 名),他们不了解任何甲状腺疾病(平均年龄为 46±10.7 岁),首次接受甲状腺 US 扫描。

结果

101 例(50.3%)受试者存在 US 甲状腺异常:91 例结节性甲状腺肿(45.2%)和 13 例 US 甲状腺炎(6.5%),其中 11 例伴有阳性自身抗体。17 例(18%)有结节的患者接受了 US 细针抽吸活检,其细胞学分类(C)结果如下:14 例患者 C2(82%),1 例患者 C3(6%),2 例患者 C4(12%),后两者接受了组织学证实。

结论

在不了解任何甲状腺疾病的受试者中,甲状腺异常的发生率非常高。DTC 在 1%的受试者和 2%的结节性甲状腺肿患者中被发现。与乳腺癌(0.45%)和结直肠癌(0.27%)筛查计划的既定检出率相比,DTC 的检出率似乎更高。甲状腺 US 筛查可以在无症状的受试者中发现 DTC,这种诊断通常包括处于晚期的 DTC。因此,US 筛查不一定会导致对无临床意义的甲状腺疾病的过度诊断。

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