单侧甲状腺乳头状癌对于对侧C-TIRADS 3类甲状腺结节的诊断价值

The diagnostic value of unilateral papillary thyroid carcinoma for contralateral C-TIRADS type 3 thyroid nodules

摘要:

目的：探讨单侧甲状腺乳头状癌(PTC)对于对侧C-TIRADS 3类甲状腺结节的诊断价值。方法：以2021年1月至2023年12月因甲状腺肿物在首都医科大学附属北京朝阳医院行甲状腺手术的患者为研究对象,对研究对象手术前的甲状腺超声及手术后的甲状腺肿物病理进行回顾性分析评估。结果：双侧的甲状腺结节,其中一侧术前甲状腺超声为C-TIRADS 4类及以上且术后病理为PTC,对侧C-TIRADS 3类甲状腺结节术后病理为恶性的概率高达41.67%。对侧C-TIRADS 3类甲状腺结节术后病理为PTC者与术后病理为非PTC者相比,其年龄≥55者与年龄<55者之间有统计学差异(χ2=6.661，P=0.01，P<0.05),其性别分布及肿物直径大小分布无统计学差异。结论：双侧的甲状腺结节患者,单侧病理提示为PTC,对侧存在C-TIRADS 3类甲状腺结节时,其对侧结节的恶性率会显著增高,且年龄<55者的对侧C-TIRADS 3类甲状腺结节术后病理更容易表现为恶性。

Abstract:

Objective To investigate the diagnostic value of unilateral papillary thyroid carcinoma (PTC) in contralateral C-TIRADS of type 3 thyroid nodules. Methods Patients undergoing thyroid surgery for goiter in Beijing Chaoyang Hospital affiliated to Capital Medical University from January 2020 to December 2022 were selected as the study objects. Thyroid ultrasound before surgery and pathology of goiter after surgery were retrospectively analyzed and evaluated. Results For bilateral thyroid nodules, one side showed C-TIRADS type 4 or above on preoperative thyroid ultrasound and postoperative pathology showed PTC, while the contralateral C-TIRADS type 3 thyroid nodules showed malignant postoperative pathology as high as 41.67%. The age of patients ≥55 and the age of patients with no PTC were compared with that of patients with no PTC. There was statistical difference among 55 patients (χ2=6.661，P=0.01，P<0.05), there were no significant differences in gender distribution and tumor diameter distribution. Conclusions In bilateral patients with thyroid nodules, unilateral pathology indicated PTC, and the presence of C-TIRADS type 3 thyroid nodules on the opposite side significantly increased the malignant rate of the contralateral nodules. The postoperative pathology of contralateral C-TIRADS type 3 thyroid nodules in <55 patients was more likely to be malignant.