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Role of Ultrasound in Decision-making of Surgery for Thyroid Nodules: A Retrospective Analysis of Cases of Peking Union Medical College Hospital in Past 11 Years
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摘要:
目的 探讨超声在甲状腺结节手术决策中的作用 目的 检索北京协和医院2004年1月至2014年12月因甲状腺结节而行手术切除的病例, 按10%~15%的比例分别对2004、2006、2008、2010、2012、2014年手术病例进行随机抽样, 查阅抽样的门诊及住院病历, 记录是否行术前超声检查, 超声报告是否给予诊断提示, 如提示则与病理结果对照判断提示是否正确。计算术前超声检查比例、超声提示诊断比例、提示诊断正确率和超声诊断正确率 结果 2004年至2014年甲状腺结节手术例数逐年上升, 其中恶性结节的比例逐年增高, 由2004年的15.65%上升至2014年的69.91%。抽样结果显示, 术前超声检查比例范围为80.65%~96.65%;超声提示诊断比例呈逐年上升趋势, 范围为46.94%~92.36%;超声提示诊断正确率在78.26%~93.62%范围内; 超声诊断正确率呈逐年上升趋势, 范围为36.73%~81.40% 结论 近年来甲状腺结节和甲状腺癌患者急剧增加, 超声诊断水平逐年提高, 在甲状腺结节的外科决策中发挥了越来越重要的作用。 Abstract:Objective To investigate the role of ultrasound in the decision-making of surgery for thyroid nodules. Methods The cases receiving surgical excision of thyroid nodules in Peking Union Medical College Hospital during the period of January 2004 to December 2014 were collected. We randomly sampled 10%-15% cases from the collections in 2004, 2006, 2008, 2010, 2012 and 2014, and reviewed the outpatient and inpatient records of these sampled cases, extracting information about whether preoperative ultrasonography examination was ordered, whether the ultrasound report provided specific diagnostic suggestion, and whether that diagnosis was correct judging from pathological results. The rates of preoperative ultrasound, ultrasound diagnostic suggestion, specific diagnostic suggestion, and correct ultrasound diagnosis were calculated. Results The number of thyroid nodule surgery increased year by year from 2004 to 2014, with the proportion of malignant nodules rising from 15.65% in 2004 to 69.91% in 2014.The rate of preoperative ultrasound ranged from 80.65% to 96.65%. The rate of ultrasound diagnostic suggestion demonstrated a constantly ascending trend, ranging from 46.94% to 92.36%. The rate of specific diagnostic suggestion was in the range of 78.26%-93.61%, while the rate of correct ultrasound diagnosis grew year by year, from 36.73% to 81.40%. Conclusions The numbers of patients with thyroid nodules and thyroid cancer have been soaring in the past 11 years. With the improvement in its diagnostic capacity, ultrasonography is playing an increasingly important role in the decision-making of surgery for thyroid nodules. -
Key words:
- thyroid nodule /
- thyroid cancer /
- ultrasound /
- diagnosis
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表 1 2004—2014年北京协和医院甲状腺结节住院手术患者超声报告抽样结果
年份 抽样
病例数抽样合格
病例数超声检查
病例数超声提示
病例数超声诊断
正确病例数2004 97 55 49 23 18 2006 115 78 65 47 44 2008 140 124 100 78 68 2010 158 114 107 68 55 2012 240 209 202 178 141 2014 330 322 301 278 245 合计 1080 902 824 672 571 
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表 2 2004—2014年北京协和医院甲状腺结节抽样患者术前超声检查及诊断指标(%)
年份 术前超声
检查比例超声提示
诊断比例超声提示
诊断正确率超声诊断
正确率2004 89.09 46.94 78.26 36.73 2006 83.33 72.31 93.62 67.69 2008 80.65 78.00 87.18 68.00 2010 93.86 63.55 80.88 51.40 2012 96.65 88.12 79.21 69.80 2014 93.48 92.36 88.13 81.40
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[1] Cooper DS, Dohery GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer:the American Thyroid Association (ATA) guidelines taskforce on thyroid nodules and differentiated thyroid cancer[J]. Thyroid, 2009, 19:1167-1214. doi: 10.1089/thy.2009.0110 [2] National Cancer Institute. SEER Stat Fact Sheets: Thyroid Cancer[EB/OL].[2014-12-08].http://seer.cancer.gov/statfacts/html/thyro.html. [3] Ahn HS, Kim HJ, Welch HG. Korea's thyroid-cancer "epidemic"-screening and overdiagnosis[J]. New Engl J Med, 2014, 371:1765-1767. doi: 10.1056/NEJMp1409841 [4] 赫捷, 陈万青.2012中国肿瘤登记年报[M].北京:军事医学科学出版社, 2014:105. [5] 中华医学会内分泌学分会, 中华医学会外科学分会内分泌学组, 中国抗癌协会头颈肿瘤专业委员会, 等.甲状腺结节和分化型甲状腺癌诊治指南[J].中华核医学与分子影像杂志, 2013, 33:96-115. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhhyx201302003 [6] Singer PA, Cooper DS, Daniels GH, et al. Treatment guide-lines for patients with thyroid nodules and well-differentiated thyroid cancer American Thyroid Association[J]. Arch Intern Med, 1996, 156:2165-2172. doi: 10.1001/archinte.1996.00440180017002 [7] Cooper DS, Dohery GM, Haugen BR, et al. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer:The American Thyroid Association Guidelines Taskforce[J]. Thyroid, 2006, 16:109-142. doi: 10.1089/thy.2006.16.109 [8] Carmeci C, Jeffrey RB, McDougall IR, et al. Ultrasound-guided fine-needle aspiration biopsy of thyroid masses[J]. Thyroid, 1998, 8:283-289. doi: 10.1089/thy.1998.8.283 [9] Muñoz Agel F, Varas Lorenzo MJ. Tridimensional (3D) ultrasonography[J]. Rev Esp Enferm Dig, 2005, 97:125-134. http://europepmc.org/abstract/MED/15801888 [10] Fernandez LJ, Aguilar A, Pardi S. Three-dimensional ultrasound in small parts:is it just a nice picture[J]. Ultrasound Q, 2004, 20:119-125. doi: 10.1097/00013644-200409000-00006 [11] Zhang B, Jiang YX, Liu JB, et al. Utility of contrast-enhanced ultrasound for evaluation of thyroid nodules[J]. Thyroid, 2010, 20:51-57. doi: 10.1089/thy.2009.0045 [12] Cantisani V, Lodisea P, Grazhdani H, et al. Ultrasound elastography in the evaluation of thyroid pathology. Current status[J]. Eur J Radiol, 2014, 83:420-428. doi: 10.1016/j.ejrad.2013.05.008 [13] Carneiro-Pla D. Ultrasound elastography in the evaluation of thyroid nodules for thyroid cancer[J]. Curr Opin Oncol, 2013, 25:1-5. doi: 10.1097/CCO.0b013e32835a87c8 -
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