单侧甲状腺乳头状癌患者对侧C-TIRADS 3类甲状腺结节的恶性风险分析

Analysis of the risk of malignancy in contralateral C-TIRADS type 3 thyroid nodules in patients with unilateral papillary thyroid carcinoma

摘要:

目的 探讨单侧甲状腺乳头状癌（PTC）患者对侧C-TIRADS 3类甲状腺结节的恶性风险。方法 选取2021年1月—2023年12月因甲状腺结节于首都医科大学附属北京朝阳医院接受甲状腺手术治疗的患者为研究对象，对患者术前甲状腺超声检查结果与术后甲状腺肿物病理诊断结果进行回顾性分析。结果 本研究纳入的108例双侧甲状腺结节患者中，当一侧结节术前甲状腺超声分类为C-TIRADS 4类及以上，且术后病理证实为PTC时，对侧C-TIRADS 3类甲状腺结节术后病理的恶性概率可达41.67%（45/108）；就对侧C-TIRADS 3类甲状腺结节的术后病理分组而言，PTC组与非PTC组在年龄分层（≥55岁/<55岁）间差异具有统计学意义（χ^2=6.661，P=0.01），两组的性别分布及结节直径分布差异均无统计学意义。结论 对于同时存在双侧甲状腺结节、单侧病理确诊为PTC且对侧合并C-TIRADS 3类甲状腺结节的患者，其对侧结节的恶性概率显著升高，且年龄<55岁患者的对侧 C-TIRADS 3类甲状腺结节提示恶变风险更高。

Abstract:

Objective To investigate the risk of malignancy in contralateral C-TIRADS type 3 thyroid nodules among patients with unilateral papillary thyroid carcinoma (PTC). Methods Patients undergoing thyroid surgery due to thyroid masses at Affiliated Beijing Chaoyang Hospital of Capital Medical University from January 2021 to December 2023 were selected as the study objects. The preoperative thyroid ultrasound results and postoperative pathological results of thyroid masses were retrospectively analyzed and evaluated. Results Among the 108 patients with bilateral thyroid nodules cases included in this study, when the nodule on one side was classified as C-TIRADS type 4 or above by preoperative thyroid ultrasound and the postoperative pathology confirmed as PTC, the contralateral C-TIRADS type 3 thyroid nodules showed malignant postoperative pathology as high as 41.67%（45/108）. In terms of the postoperative pathological classification of the contralateral C-TIRADS type 3 thyroid nodules, there was a statistically significant difference in age stratification (≥55 years/<55 years) between the PTC group and the non-PTC group(χ²=6.661，P=0.01), and there were no statistically significant differences in gender distribution and nodule diameter distribution between the two groups. Conclusions For patients with bilateral thyroid nodules, unilateral pathological diagnosis of PTC and concurrent C-TIRADS type 3 thyroid nodules on the contralateral side, the malignancy probability of the contralateral nodules significantly increases. Moreover, for patients with age <55 years, the postoperative pathological diagnosis of contralateral C-TIRADS type 3 thyroid nodules is more likely to indicate malignant lesions.