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对最初诊断为良性的甲状腺结节患者使用超声进行随访检查的评估

Evaluation of Follow-up Examinations Using Ultrasonography for Patients With Thyroid Nodules Initially Diagnosed as Benign.

作者信息

Oki Toyokazu, Sugimoto Takeki, Ogawa Maho, Dabanaka Ken, Namikawa Tsutomu, Hanazaki Kazuhiro

机构信息

Breast Center, Kochi Medical School Hospital, Kochi Medical School, Kochi, Japan.

Department of Surgery, Kochi Medical School, Kochi, Japan.

出版信息

Anticancer Res. 2019 Apr;39(4):2061-2067. doi: 10.21873/anticanres.13317.

Abstract

BACKGROUND/AIM: The aim of this study was to determine the natural history of benign thyroid nodules using ultrasonography.

PATIENTS AND METHODS

The records of 223 patients with benign thyroid nodules treated at the Kochi Medical School from 2010 to 2012 were reviewed retrospectively. Repeated ultrasonography was performed, and the findings were directly compared with previous images.

RESULTS

The median change in the size of the nodules was 0.01 cm/year, although the size of six nodules (2.7%) increased more than 0.5 cm/year, and these nodules were removed surgically. Nineteen patients (8.5%) underwent surgery during the follow-up period. Compared to those who did not undergo surgery, the size of the nodules was larger and the rate of change in nodule diameter was higher in those undergoing surgery. The pathological diagnosis based on repeated fine needle aspiration cytology was benign nodules in 16 patients and papillary cancer in three patients.

CONCLUSION

Even if a thyroid nodule is initially diagnosed as benign, it may have malignant potential. Therefore, so as not to miss malignancies, nodules should be carefully re-evaluated to assess their growth or change in size using ultrasonography.

摘要

背景/目的:本研究的目的是利用超声检查确定甲状腺良性结节的自然病程。

患者与方法

回顾性分析2010年至2012年在高知医科大学接受治疗的223例甲状腺良性结节患者的病历。进行了重复超声检查,并将检查结果与之前的图像直接对比。

结果

结节大小的中位数变化为每年0.01厘米,不过有6个结节(2.7%)的大小每年增加超过0.5厘米,这些结节接受了手术切除。19例患者(8.5%)在随访期间接受了手术。与未接受手术的患者相比,接受手术患者的结节更大,结节直径变化率更高。基于重复细针穿刺细胞学检查的病理诊断结果为,16例患者为良性结节,3例患者为乳头状癌。

结论

即使甲状腺结节最初被诊断为良性,它仍可能具有恶性潜能。因此,为了不遗漏恶性病变,应使用超声检查仔细重新评估结节,以评估其生长情况或大小变化。

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