贵州医科大学学报

2016, v.41;No.184(01) 88-91

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1553例甲状腺结节手术患者临床特征分析
Analysis of Clinical Features of 1 553 Patients with Thyroid Nodules

唐鲲;时立新;何德奇;
TANG Kun;SHI Lixin;HE Deqi;Department of Internal Medicine,Guizhou Medical University;Department of Endocrine,Affiliated Hospital of Guizhou Medical University;

摘要(Abstract):

目的:分析1 553例甲状腺结节手术患者的临床特征。方法:收集1 553例手术治疗的甲状腺结节患者性别、年龄,记录甲状腺结节的部位、数量及大小,检测患者术前血清促甲状腺激素(TSH)水平,根据术后病理诊断结果分型,比较不同类型的甲状腺结节的临床特征。结果:甲状腺结节发病年龄以40~49岁比例最大,女性患病高于男性(1∶5.66);甲状腺恶性结节女性40~49岁高发(29.3%),男性30~39岁高发(25.5%);1 553例手术患者中,发现甲状腺乳头状癌233例(84.4%),甲状腺滤泡癌5例(1.8%),甲状腺滤泡性乳头状癌25例(9.1%),甲状腺未分化癌3例(1.1%),甲状腺低分化癌4例(1.4%),甲状腺髓样癌1人(0.4%),其他类型5例(1.8%),甲状腺恶性结节的患病率与性别无明显相关性(OR=0.754,P>0.05);分化型甲状腺癌发病率与术前血清TSH浓度呈正相关(OR=1.29,P<0.01),直径>10 mm的分化型甲状腺癌较直径≤10 mm的分化型甲状腺癌更易发生淋巴结转移。结论:甲状腺乳头状癌仍是目前临床最常见的甲状腺恶性结节,分化型甲状腺癌的患病率与术前血清TSH水平呈正相关,直径>10 mm的分化型甲状腺癌更易发生淋巴结转移。
Objective: To discuss clinical features of 1 553 patients with thyroid nodules. Methods:A total of 1 553 patients with thyroid nodules were selected,and collecting information including gender,age,the part of the thyroid nodule,quantity and size,serum TSH concentration and pathological reports. Results: The age of largest proportion of patients with thyroid nodules was 40 ~ 49 years old.The prevalence rate of female patients was more than male patients( 1∶ 5. 66). Malignant thyroid nodules usually happened in female groups aged 40 ~ 49( 29. 3%) and male groups aged 30 ~ 39( 25. 5%). Malignant thyroid nodules included 233 cases of thyroid papillary carcinoma( 84. 4%),5cases of follicular carcinoma( 1. 8%),25 cases of mixed follicular and papillary thyroid carcinoma( 9. 1%),3 cases of anaplastic thyroid carcinoma( 1. 1%),4 cases of low differentiated thyroid carcinoma( 1. 4%),1 cases of medullary thyroid carcinoma( 0. 4%),5 cases of other types( 1. 8%).The relationship between the prevalence of thyroid malignant nodules and gender was not significant( OR = 0. 754,P > 0. 05). The incidence of differentiated thyroid carcinoma was positively correlated with preoperative serum TSH concentration( OR = 1. 29,P < 0. 01). Differentiated thyroid cancer whose diameter was more than 10 mm was more prone to lymph node metastasis. Conclusion: Thyroid papillary carcinoma is the most common malignant thyroid nodules. Preoperative serum TSH is more important in the relevant factors of thyroid nodules,the incidence of differentiated thyroid carcinoma was positively correlated with preoperative serum TSH concentration. Differentiated thyroid cancer whose diameter was more than 10 mm was more prone to lymph node metastasis.

关键词(KeyWords): 甲状腺结节;甲状腺肿瘤;危险因素;诊断;病理学
thyroid nodule;thyroid neoplasms;risk factor;diagnosis;pathology

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作者(Author): 唐鲲;时立新;何德奇;
TANG Kun;SHI Lixin;HE Deqi;Department of Internal Medicine,Guizhou Medical University;Department of Endocrine,Affiliated Hospital of Guizhou Medical University;

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DOI: 10.19367/j.cnki.1000-2707.2016.01.025

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