撒哈拉以南国家一家医院人群中不可触及甲状腺偶发瘤的超声患病率及特征
Ultrasonographic prevalence and characteristics of non-palpable thyroid incidentalomas in a hospital-based population in a sub-Saharan country.
作者信息
Moifo Boniface, Moulion Tapouh Jean Roger, Dongmo Fomekong Sylviane, Djomou François, Manka'a Wankie Emmanuella
机构信息
Department of Radiology and Radiation Oncology, Faculty of Medicine and Biomedical Sciences, The University of Yaounde 1, Yaounde, Cameroon.
Radiology Department YGOPH, Yaounde Gynaeco-Obstetric and Pediatric Hospital, PO Box 4362, Yaounde, Cameroon.
出版信息
BMC Med Imaging. 2017 Mar 4;17(1):21. doi: 10.1186/s12880-017-0194-8.
BACKGROUND
Thyroid incidentalomas (TI) are highly prevalent asymptomatic thyroid nodules with ultrasound as the best imaging modality for their detection and characterization. Although they are mostly benign, potential for malignancy is up to 10-15%. In sub-Saharan Africa little data exists on the prevalence and risk categorization of TI. The aim of this study was to determine the prevalence and ultrasound characteristics of non-palpable thyroid incidentalomas among adults in sub-Saharan setting.
METHODS
A cross sectional study was carried out between March and August 2015, at two university teaching hospitals. Sampling was consecutive and included all adults aged ≥ 16 years, presenting for any ultrasound other than for the thyroid, with no history or clinical signs of thyroid disease, and no palpable thyroid lesion. Ultrasound was done using 4 to 11 MHz linear probes. Subjects with diffuse thyroid abnormalities were excluded. Variables studied were age, gender, thyroid volume, ultrasound characteristics of thyroid nodules, TIRADS scores. Differences were considered statistically significant for p-value < 0.05.
RESULTS
The prevalence of TI was 28.3% (126 persons with TI /446 examined). This prevalence was 46.2% in population ≥ 61-year-old; 6.3% in population ≤ 20-year-old; 33.3% for females and 18.4% for males (p < 0.001). Of the 241 TI found, 49.4% were cysts, 33.6% solid, 17.0% mixed; 37.8% <5 mm and 22% >10 mm. Solid TI were mainly hyperechoic (42.0%), 3/81 were markedly hypoechoic. Sixty-nine out of 126 persons with TI (54.8%) had at least two nodules. Solitary nodules were predominant in the age group ≤20 years. Of 241 TI, 129 (53.5%) were classified TIRADS 2, 81 (33.6%) TIRADS 3, 25 (10.4%) TIRADS 4A, 6 (2.5%) TIRADS 4B, and none TIRADS 5. Characteristics associated with increased risk of malignancy where mostly founded on solid nodules (p < 0.000) and nodules larger than 15 mm (p < 0.001).
CONCLUSION
Thyroid incidentalomas were very frequent with a prevalence of 28.3% and potential risk of malignancy in 12.9%. Prevalence had a tendency to increase with age and in female. Cystic nodules were the most prevalent. Potential for malignancy would be increased for larger and solid nodules.
背景
甲状腺偶发瘤（TI）是高度常见的无症状甲状腺结节，超声是检测和鉴别其特征的最佳影像学检查方法。尽管它们大多为良性，但恶变可能性高达10%-15%。在撒哈拉以南非洲地区，关于TI的患病率和风险分类的数据很少。本研究的目的是确定撒哈拉以南地区成年人中不可触及的甲状腺偶发瘤的患病率及超声特征。
方法
2015年3月至8月在两家大学教学医院进行了一项横断面研究。采用连续抽样，纳入所有年龄≥16岁、因甲状腺以外的任何超声检查就诊、无甲状腺疾病病史或临床体征且未触及甲状腺病变的成年人。使用4至11MHz线性探头进行超声检查。排除甲状腺弥漫性异常的受试者。研究的变量包括年龄、性别、甲状腺体积、甲状腺结节的超声特征、甲状腺影像报告和数据系统（TIRADS）分类。p值<0.05时差异被认为具有统计学意义。
结果
TI的患病率为28.3%（126例TI患者/446例受检者）。61岁及以上人群中的患病率为46.2%；20岁及以下人群中的患病率为6.3%；女性患病率为33.3%，男性患病率为18.4%（p<0.001）。在发现的241个TI中，49.4%为囊肿，33.6%为实性，17.0%为混合性；37.8%<5mm，22%>10mm。实性TI主要为高回声（42.0%），81个中有3个为明显低回声。126例TI患者中有69例（54.8%）至少有两个结节。孤立结节在20岁及以下年龄组中占主导。在241个TI中，129个（53.5%）被分类为TIRADS 2类，81个（33.6%）为TIRADS 3类，25个（10.4%）为TIRADS 4A类，6个（2.5%）为TIRADS 4B类，无TIRADS 5类。与恶性风险增加相关的特征主要基于实性结节（p<0.000）和大于15mm的结节（p<0.001）。
结论
甲状腺偶发瘤非常常见，患病率为28.3%，恶变潜在风险为12.9%。患病率有随年龄增长和女性增加的趋势。囊性结节最为常见。较大和实性结节的恶变可能性会增加。
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