Durfee Sara M, Benson Carol B, Arthaud Dylan M, Alexander Erik K, Frates Mary C
Department of Radiology (S.M.D., C.B.B., M.C.F.) and Department of Medicine, Thyroid Section, Division of Endocrinology, Hypertension, and Diabetes (D.M.A., E.K.A.), Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts USA.
J Ultrasound Med. 2015 Apr;34(4):697-704. doi: 10.7863/ultra.34.4.697.
To determine whether the sonographic appearance of thyroid cancer differs in patients with and without Hashimoto thyroiditis.
Patients with histologically proven thyroid cancer who had thyroid peroxidase (TPO) antibodies measured and sonography performed preoperatively were included. We evaluated each nodule for size, echogenicity, composition, margins, halo, and vascularity and evaluated the background heterogeneity of the gland.
There were 162 thyroid cancers in 145 patients. Forty-two patients (29.0%) had Hashimoto thyroiditis with positive TPO antibodies, and 103 patients (71.0%) had negative TPO antibodies. The background echogenicity was more often heterogeneous in TPO antibody-positive patients compared to those who had negative TPO antibodies (57.1% versus 26.2%; P= .0005). Comparing cancers in TPO antibody-positive to TPO antibody-negative patients, there was no significant difference in the size, echogenicity, composition, margins, halo presence, calcification presence and type, or vascularity of the cancerous nodule (P > .05). Among TPO antibody-positive patients, comparing thyroid cancerous nodules in patients with heterogeneous glands to those with homogeneous glands, there was no significant difference in any sonographic characteristic except the margin of the nodule, which was more often irregular or poorly defined in heterogeneous glands and more often smooth in homogeneous glands (P< .05).
Sonographic features of thyroid cancer are similar in patients with and without Hashimoto thyroiditis. Among patients with Hashimoto thyroiditis and thyroid cancer, the sonographic appearance of the cancerous nodule is similar, except that cancerous nodule margins are more likely to be irregular or poorly defined when the gland is heterogeneous.
确定患有和未患有桥本甲状腺炎的患者中甲状腺癌的超声表现是否存在差异。
纳入术前测量过甲状腺过氧化物酶（TPO）抗体并进行了超声检查且组织学确诊为甲状腺癌的患者。我们评估了每个结节的大小、回声性、成分、边界、晕环和血管情况，并评估了腺体的背景异质性。
145例患者中有162例甲状腺癌。42例患者（29.0%）患有桥本甲状腺炎且TPO抗体呈阳性，103例患者（71.0%）TPO抗体呈阴性。与TPO抗体阴性的患者相比，TPO抗体阳性的患者背景回声更常呈不均匀性（57.1%对26.2%；P = 0.0005）。比较TPO抗体阳性患者与TPO抗体阴性患者的癌症，癌结节的大小、回声性、成分、边界、晕环的存在、钙化的存在及类型或血管情况均无显著差异（P>0.05）。在TPO抗体阳性的患者中，比较腺体不均匀的患者与腺体均匀的患者的甲状腺癌结节，除结节边界外，其他超声特征均无显著差异，不均匀腺体中的结节边界更常不规则或边界不清，而均匀腺体中的结节边界更常光滑（P<0.05）。
患有和未患有桥本甲状腺炎的患者中甲状腺癌的超声特征相似。在患有桥本甲状腺炎和甲状腺癌的患者中，癌结节的超声表现相似，只是当腺体不均匀时，癌结节边界更可能不规则或边界不清。
