Incidence of microcarcinoma and non-microcarcinoma in ultrasound-found thyroid nodules

被引：6

作者：

Chen, Zhi ^{[2
]}

Mosha, Singla Sethiel ^{[1
]}

Zhang, Tong ^{[2
]}

Xu, Ming ^{[3
]}

Li, Yanli ^{[1
]}

Hu, Zhuoqing ^{[1
]}

Liang, Weiqiang ^{[4
]}

Deng, Xiaoyi ^{[1
]}

Ou, Tingting ^{[1
]}

Li, Ling ^{[1
]}

Li, Wangen ^{[1
]}

机构：

[1] Guangzhou Med Univ, Affiliated Hosp 2, Dept Endocrinol, 250 Changgang Rd East, Guangzhou 510260, Peoples R China

[2] Southern Med Univ, Affiliated Hosp 3, Dept Endocrinol, 183 Zhongshan Ave West, Guangzhou 510630, Peoples R China

[3] Guangzhou Med Univ, Affiliated Hosp 2, Dept Med Ultrasound, 250 Changgang Rd East, Guangzhou 510260, Peoples R China

[4] Southern Med Univ, Affiliated Nanhai Hosp, Dept Endocrinol, 40 Foping Rd, Foshan 528200, Peoples R China

来源：

BMC ENDOCRINE DISORDERS | 2021年 / 21卷 / 01期

关键词：

Thyroid nodules; Ultrasound; Carcinomas; Screen; ACTIVE SURVEILLANCE; DATA SYSTEM; TASK-FORCE; CANCER; SIZE; ASSOCIATION; MALIGNANCY; MANAGEMENT; IMPACT; PREVALENCE;

D O I：

10.1186/s12902-021-00700-1

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BackgroundsThe incidence of thyroid nodules is increasing year by year around the world. However, ultrasound is not recommended as a screening test for the general population or patients with a normal thyroid on palpation by the American Association of Clinical Endocrinologists (AACE). In practice, some individuals with normal thyroid palpation have nodules that can just be found out by ultrasound. No studies have directly described the risk of nodules found by ultrasound or by palpation up to now. More evidence is needed to carry out for helping us balance the over diagnosis and missed diagnosis of malignant lesions. Therefore, we carried out a retrospective study to investigate the incidence of malignant lesions in ultrasound-found nodules in a large cohort.MethodsWe conducted a retrospective analysis involving 2957 patients who underwent thyroid ultrasound evaluation and fine-needle aspiration (FNA) between Jan 2013 and Dec 2019. The cytologic examinations were analyzed based on the Bethesda system. For nodules suspected to be follicular neoplasm or other malignant tumors by cytological tests, patients were recommended for surgery and histopathology examinations.ResultsCompared with palpation-found nodules, ultrasound-found nodules were presenting less as purely cystic nodules (10.1% vs. 39.9%, x(2)=355.69, p=0.000), smaller size (17.59.9 mm vs. 28.0 +/- 12.5 mm, t=23.876 p=0.000), and higher TI-RADS score (5.5 +/- 2.9 vs. 3.4 +/- 3.3, t=18.084, p=0.000), respectively. More ultrasound-found nodules were diagnosed as carcinoma by histology examinations [136 (11.2%) nodules found by ultrasound vs. 68 (3.9%) by palpation, x(2)=59.737, p=0.000], and 88 (64.7%) nodules found by ultrasound were non-microcarcinoma. Among the malignant nodules confirmed by histopathology, a higher proportion of microcarcinoma was detected in ultrasound-found nodules [35.3% (48/136) vs. 16.2% (11/68), x(2)=8.183, p=0.004].Conclusions In view of the results observed in our research, malignant nodules were more common in nodules screened out by ultrasound, and nearly two thirds of them were non-microcarcinoma. We suggest the recommendation against screening thyroid nodules by ultrasound needs to be re-evaluated.

引用

页数：5

共 23 条

[1] Thyroid Cancer Screening in South Korea Increases Detection of Papillary Cancers with No Impact on Other Subtypes or Thyroid Cancer Mortality [J].