Nutz V, Larena-Avellaneda A, Wunsch E, Kämper A
Dtsch Med Wochenschr. 1984 Aug 31;109(35):1319-21. doi: 10.1055/s-2008-1069370.
Goitre operations were done in 2114 patients; 1648 patients had a simple solitary nodule or multinodular goitre with regressive changes. Malignancies were found in 54 cases with a clear-cut predominance of papillary carcinomas. Nearly half of the goitres diagnosed as solitary nodules preoperatively were shown to be multinodular. This discrepancy was taken into account in the determination of the rate of malignancy. Malignomas were found in 4.6% of "true" solitary nodules and in 2.8% in multinodular goitres. These findings confirm our liberal indications for operation in multinodular goitres with regressive changes also in the area of endemic goitre. The high incidence of microcarcinomas in our patients can thus be explained.
对2114例患者进行了甲状腺手术；1648例患者患有单纯性孤立结节或伴有退行性变的多结节性甲状腺肿。在54例中发现了恶性肿瘤，其中乳头状癌明显占主导。术前诊断为孤立结节的甲状腺肿中，近一半被证明是多结节性的。在确定恶性率时考虑到了这种差异。在“真正的”孤立结节中发现恶性肿瘤的比例为4.6%，在多结节性甲状腺肿中为2.8%。这些发现证实了我们对于伴有退行性变的多结节性甲状腺肿（包括地方性甲状腺肿地区）采取较为宽松的手术指征是合理的。因此可以解释我们患者中微癌的高发病率。
