533例40岁以上甲状腺结节患者的术后分析

发布时间：2018-08-23 12:27

【摘要】：目的:分析40岁以上患者甲状腺结节病变特点,评价术前超声、细针穿刺抽吸活检诊断甲状腺结节的价值。方法:收集贵阳医学院附属医院甲状腺外科2011年2月~2013年12月行甲状腺结节手术治疗且年龄≥40岁患者533例病历资料,整理患者年龄、性别及病理类型和甲状腺结节良恶性的构成,分析术前促甲状腺激素水平与甲状腺结节良恶性关系;以术后病理结果为标准评价患者术前超声、细针穿刺抽吸活检诊断的准确性;以结节良恶性为因变量采用多因素logistic回归分析方法预测甲状腺恶性结节的危险因素。结果:(1)40~59岁年龄段好发甲状腺结节,男女之比为1:5.92;(2)甲状腺结节男、女恶性率分别为23.4%、13.6%;(3)甲状腺结节病理类型中结节性甲状腺肿和腺瘤占68.3%,甲状腺乳头状癌占13.5%,其余甲状腺滤泡癌、髓样癌及其他占1.6%;(4)单发、实性、大结节恶性率高于多发、混合性结节,囊性结节恶变性较低;(5)术前超声、细针穿刺抽吸活检诊断与术后病理结果对比符合率分别为82.8%、94.9%;(6)随着TSH水平增高恶性结节比例随之增加。结论:40岁以上甲状腺结节患者恶性率男性高于女性,术前超声、细针穿刺抽吸活检在结节良恶性鉴别上有重要的诊断价值。
[Abstract]:Objective: to analyze the characteristics of thyroid nodule lesions in patients over 40 years old and evaluate the value of preoperative ultrasound and fine needle aspiration biopsy in the diagnosis of thyroid nodules. Methods: from February 2011 to December 2013, 533 patients with thyroid nodules aged more than 40 years were treated by thyroid surgery in affiliated Hospital of Guiyang Medical College. Sex, pathological type and the composition of benign and malignant thyroid nodules, the relationship between preoperative thyroid stimulating hormone levels and benign and malignant thyroid nodules was analyzed, and preoperative ultrasound was used to evaluate the postoperative pathological results. The accuracy of fine needle aspiration biopsy in diagnosis and the risk factors of thyroid malignant nodules were predicted by multivariate logistic regression analysis with benign and malignant nodules as dependent variables. Results: (1) thyroid nodules were common in the age group of 40 to 59 years old, the ratio of male to female was 1: 5.92; (2) the malignant rate of thyroid nodule was 23.4and 13.6in male, and (3) in the pathological type of thyroid nodule, nodular goiter and adenoma were 68.3%, papillary thyroid carcinoma was 13.5th and thyroid follicular carcinoma was other thyroid follicular carcinoma. (4) the malignant rate of single, solid and large nodules is higher than that of multiple, mixed nodules, cystic nodule malignancy is lower. (5) preoperative ultrasound, The coincidence rates of fine needle aspiration biopsy diagnosis and postoperative pathological results were 82.8% and 94.9% respectively. (6) the proportion of malignant nodules increased with the increase of TSH level. Conclusion the malignant rate of thyroid nodule over 40 years old is higher in male than in female. Preoperative ultrasound and fine needle aspiration biopsy have important diagnostic value in differentiating benign and malignant nodules.
【学位授予单位】：贵阳医学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R581

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