Sarda A K, Bal S, Kapur M M
Department of Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi.
Jpn J Surg. 1988 Jul;18(4):409-14. doi: 10.1007/BF02471465.
A retrospective analysis of 66 cases of thyroid cancer presenting as a solitary thyroid nodule (STN) from an endemic area is presented herein. The workup included TSH estimation and radionuclide scanning and patients were divided into two groups. Group A included cases of STN carcinoma diagnosed histologically in patients clinically presenting as a benign STN. Of all the patients who presented with a benign STN, malignancy was found more frequently in 'cold' nodules (13.5 per cent), than in nodules with a different presentation on scintiscanning (0-9.5 per cent). Cancers occurred in 5 per cent of the females and in 19.5 per cent of the males. Group B included patients with overt signs of malignancy. In both groups, the clinical behaviour was determined by the stage at presentation according to TNM classification. TNM staging was found to be a good prognostic indicator, comparable to histopathology. Thus, locoregional recurrence and mortality were found to be higher in advanced T3 lesions and in Group B patients. On the basis of these findings it is suggested that STN cancers may either be an earlier stage of the disease or that the STN cancers in the two groups may be separate disease entities.
本文对来自地方性甲状腺肿流行地区的66例表现为甲状腺单发结节（STN）的甲状腺癌病例进行了回顾性分析。检查包括促甲状腺激素（TSH）测定和放射性核素扫描，患者被分为两组。A组包括临床上表现为良性STN但经组织学诊断为STN癌的病例。在所有表现为良性STN的患者中，“冷”结节的恶性肿瘤发生率（13.5%）高于放射性核素扫描表现不同的结节（0 - 9.5%）。女性患者的癌症发生率为5%，男性患者为19.5%。B组包括有明显恶性体征的患者。在两组中，临床行为根据TNM分类由就诊时的分期决定。发现TNM分期是一个良好的预后指标，与组织病理学相当。因此，在晚期T3病变患者和B组患者中，局部区域复发率和死亡率较高。基于这些发现，有人提出STN癌可能要么是疾病的早期阶段，要么两组中的STN癌可能是不同的疾病实体。
