Wang Meng, Ma Shaogang, Jiang Guangwei, Du Delian
Department of Endocrinology and Metabolism, Linping Campus, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, CHN.
Department of Endocrinology and Metabolism, The People's Hospital of Laibin, Laibin, CHN.
Cureus. 2024 Nov 29;16(11):e74780. doi: 10.7759/cureus.74780. eCollection 2024 Nov.
Objective To investigate the clinical characteristics of nodular goitre (NG) and the relationship between NG and papillary thyroid carcinoma (PTC). Methods A total of 282 consecutive patients suspicious for thyroid cancer were enrolled. All the patients underwent surgical resection of the thyroid. Laboratory tests, ultrasonography, and pathology data were compared between patients with and without NG. Results Of the 282 patients who underwent surgery, 124 were diagnosed with PTC by pathology. NG accounted for 48.9% (138/282) of all patients, with a male-to-female ratio of 1:3. The rates of PTC and haemorrhage in patients with NG were 23.2% (31/138) and 29.0% (40/138), respectively, both of which were greater than those in patients without NG (p < 0.001). The levels of thyroid-stimulating hormone (TSH) and carcinoembryonic antigen (CEA) in patients with PTC were 2.2 µIU/mL (min, 0.4; max, 109.8) (p = 0.04) and 1.16 ng/mL (0, 2.17, p25, p75) (p < 0.001), respectively, both of which were greater than those in patients with NG. However, the levels of thyroglobulin, thyroglobulin antibodies, and thyroid peroxidase antibodies were not significantly different. Conclusions The proportion of NG in thyroid surgery is very high, and NG carries a high risk of PTC, suggesting that elevated TSH and CEA are closely related to PTC.
目的 探讨结节性甲状腺肿（NG）的临床特征以及NG与甲状腺乳头状癌（PTC）之间的关系。方法 连续纳入282例疑似甲状腺癌的患者。所有患者均接受甲状腺手术切除。比较有和没有NG的患者的实验室检查、超声检查及病理数据。结果 在接受手术的282例患者中，124例经病理诊断为PTC。NG占所有患者的48.9%（138/282），男女比例为1:3。NG患者的PTC发生率和出血率分别为23.2%（31/138）和29.0%（40/138），均高于无NG的患者（p<0.001）。PTC患者的促甲状腺激素（TSH）和癌胚抗原（CEA）水平分别为2.2 μIU/mL（最小值，0.4；最大值，109.8）（p=0.04）和1.16 ng/mL（0，2.17，p25，p75）（p<0.001），均高于NG患者。然而，甲状腺球蛋白、甲状腺球蛋白抗体和甲状腺过氧化物酶抗体水平无显著差异。结论 NG在甲状腺手术中的比例非常高，且NG伴有较高的PTC风险，提示TSH和CEA升高与PTC密切相关。
