Department of Internal Medicine, Korea Cancer Center Hospital, 75, Nowon-ro, Nowon-gu, Seoul, 139-706, Republic of Korea.
Endocr Pathol. 2013 Dec;24(4):177-83. doi: 10.1007/s12022-013-9263-x.
In cases of follicular neoplasm identified by thyroid fine-needle aspiration (FNA), surgery is required to achieve a precise diagnosis. We investigated potential clinical factors for the preoperative prediction of malignancy in thyroid nodules with a cytological diagnosis of follicular neoplasm. We retrospectively reviewed the data of 97 patients who were diagnosed with follicular neoplasm by FNA and had undergone surgery at the Korea Cancer Center Hospital between April 2010 and April 2012. Age, sex, laboratory data (such as thyroid-stimulating hormone, free T4, thyroglobulin (Tg), and Tg antibody), and ultrasonographic findings were reviewed from the electronic medical records. Of 97 patients, 50 (51.5 %) were diagnosed with benign nodules, 16 (16.5 %) with follicular thyroid carcinoma (FTC), and 31 (32.0 %) with papillary thyroid carcinoma (PTC). In comparison with the features of benign nodules, FTC presented with a large nodule size, high serum Tg level, isoechogenicity, calcifications, and peripheral halo, whereas PTC exhibited traits similar to those of benign nodules, except for high serum Tg level and the presence of calcifications on ultrasonography. Therefore, a high serum Tg level (≥75 ng/mL) and calcification were the only significant predictive factors for malignancy in case of follicular neoplasm (p < 0.01). Serum Tg levels and the presence of calcification on ultrasonography are important clinical features to predict malignancy in thyroid nodules with cytological diagnosis of follicular neoplasm.
在甲状腺细针抽吸（FNA）确定滤泡性肿瘤的情况下，需要手术以获得准确的诊断。我们研究了术前预测细胞学诊断为滤泡性肿瘤的甲状腺结节恶性肿瘤的潜在临床因素。我们回顾性分析了 2010 年 4 月至 2012 年 4 月期间在韩国癌症中心医院接受 FNA 诊断为滤泡性肿瘤并接受手术的 97 例患者的数据。从电子病历中回顾了年龄、性别、实验室数据（如促甲状腺激素、游离 T4、甲状腺球蛋白（Tg）和 Tg 抗体）和超声检查结果。在 97 例患者中，50 例（51.5%）诊断为良性结节，16 例（16.5%）诊断为滤泡甲状腺癌（FTC），31 例（32.0%）诊断为甲状腺乳头状癌（PTC）。与良性结节的特征相比，FTC 表现为结节较大、血清 Tg 水平较高、等回声、钙化和周边晕环，而 PTC 表现为与良性结节相似的特征，除了血清 Tg 水平较高和超声检查有钙化。因此，高血清 Tg 水平（≥75ng/mL）和钙化是滤泡性肿瘤（p<0.01）恶性的唯一显著预测因素。血清 Tg 水平和超声检查中钙化的存在是预测细胞学诊断为滤泡性肿瘤的甲状腺结节恶性的重要临床特征。
