偶然但并非无关紧要:患有格雷夫斯病的患者的甲状腺癌
Rongzhi Wang1, Mitchell Disharoon1, Zhixing Song1
1From the Department of Surgery, University of Alabama at Birmingham, Birmingham, AL (Wang, Disharoon, Song, Gillis, Fazendin, Lindeman, Chen, McMullin).
Journal of the American College of Surgeons
|January 17, 2024
概括
接受全甲状腺切除术 (TTx) 的格雷夫斯病患者有6.4%的偶然发现的甲状腺癌 (TC) 发生率. 手术前的测试往往无法检测出这种偶然的甲状腺癌,这凸显了它在管理决策中的重要性.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 病理学 病理学 病理学
背景情况:
- 格雷夫斯病是美国甲状腺功能障碍的主要原因.
- 全甲状腺切除术 (TTx) 是对格雷夫斯病的一种手术选择,虽然比抗甲状腺药物或放射性更少.
- 偶然的甲状腺癌 (TC) 可以在接受TTx的Graves病患者中发现,这是非手术治疗错过的发现.
研究的目的:
- 确定在接受全甲状腺切除术 (TTx) 的格雷夫斯病患者中偶然发现甲状腺癌 (TC) 的发病率.
主要方法:
- 在2011年至2023年期间接受TTx的934名格雷夫斯病患者的回顾性审查.
- 病理学报告被分析为偶然的TC.
- 人口统计数据,手术前评估,医疗管理和手术结果的比较,这些数据包括有和没有意外TC的患者.
主要成果:
- 在6.4% (60/934) 的患者中发现了偶然的TC.
- 乳头甲状腺癌是最常见的类型 (58.3%),其次是乳头小瘤 (33.3%).
- 手术前的超声波和细针吸收显示TC预测的准确性较低,许多初始结果是良性的.
结论:
- 在接受TTx的格雷夫斯病患者中,偶然TC的发生率显著 (6.4%).
- 术前的诊断工具,如超声波和细针吸收,往往是不可靠的,用于检测偶然的TC.
- 在讨论格雷夫斯病的最终管理选择时,应考虑偶然TC的可能性.
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