甲状腺结节的检测方法：与细针穿刺频率及恶性率的相关性
Method of detection of thyroid nodules: correlation with frequency of fine-needle aspiration and malignancy rate.
作者信息
Rothberger Gary D, Cohen Melissa, Sahay Priya, Szczepanczyk Paula T, Islam Shahidul
机构信息
Division of Endocrinology, Diabetes and Metabolism, NYU Winthrop Hospital, Mineola, New York.
Department of Medicine, NYU Winthrop Hospital, Mineola, New York.
出版信息
Head Neck. 2020 Feb;42(2):210-216. doi: 10.1002/hed.25984. Epub 2019 Oct 15.
BACKGROUND
Thyroid nodules are commonly found by screening, and the clinical implications are unclear.
METHODS
We retrospectively studied 460 patients who were evaluated for thyroid nodules. Medical records were queried to determine how the nodules were detected. We compared the rates of fine needle aspiration (FNA) and malignancy between nodules detected clinically, incidentally on imaging, or by screening.
RESULTS
Nodules were detected clinically in 184 patients (40%), incidentally in 121 patients (26%), and by screening in 155 patients (34%). The rates of FNA and malignancy were lower for patients with nodules detected by screening (28% and 1%, respectively), compared to patients with clinically apparent nodules (75% and 15%) and patients with incidental nodules (69% and 8% [P < .001]).
CONCLUSION
Thyroid nodules detected via screening has a lower rate of FNA and is less likely to be diagnosed as a malignancy compared to nodules detected clinically or incidentally on imaging. Thyroid ultrasound examinations should be reserved for nodules that are clinically apparent or to evaluate nodules found incidentally on imaging.
背景
甲状腺结节通常通过筛查发现，其临床意义尚不清楚。
方法
我们回顾性研究了460例接受甲状腺结节评估的患者。查询病历以确定结节的检测方式。我们比较了临床检测到的结节、影像学检查偶然发现的结节或筛查发现的结节的细针穿刺活检（FNA）率和恶性率。
结果
184例患者（40%）的结节为临床检测到，121例患者（26%）的结节为偶然发现，155例患者（34%）的结节为筛查发现。与临床明显结节患者（分别为75%和15%）以及偶然发现结节患者（69%和8%[P < 0.001]）相比，筛查发现结节的患者FNA率和恶性率较低（分别为28%和1%）。
结论
与临床检测到的结节或影像学检查偶然发现的结节相比，通过筛查发现的甲状腺结节FNA率较低，被诊断为恶性的可能性也较小。甲状腺超声检查应仅用于临床明显的结节或评估影像学检查偶然发现的结节。
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