在细胞学上不确定的甲状腺结节中对癌症风险的单变量和多变量分析:单中心体验
Enrico Battistella1, Marica Mirabella1, Luca Pomba1
1Endocrine Surgery Unit, Department of Surgery, Veneto Institute of Oncology, IOV-IRCCS, Via Gattamelata 64, 35128 Padua, Italy.
Cancers
|March 13, 2024
概括
不确定的甲状腺结节 (TIR3A/3B) 构成恶性瘤的重大风险. 建议对TIR3A进行外科干预,对于TIR3B结节是强制性的,以确保准确的诊断和及时的治疗.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 手术病理学手术病理学
背景情况:
- 结节性甲状腺病理很常见,其中很大一部分是细胞学上不确定的 (TIR3A / 3B).
- 现有的文献表明,TIR3A的恶性瘤风险为5-15%,TIR3B的风险为15-30%,在实践中可能被低估.
研究的目的:
- 分析未确定结节性甲状腺疾病患者的临床风险因素和手术前血清标志物.
- 为了确定恶性瘤的风险,并指导TIR3A和TIR3B甲状腺结节的外科治疗.
主要方法:
- 对291名因未确定的结节性甲状腺疾病接受手术的患者进行了回顾性审查.
- 临床特征,并发症,超声波特征和组织学报告的单变量和多变量分析.
- 良性和恶性结节性甲状腺疾病群体之间的统计比较,使用奇平方和费舍尔精确测试.
主要成果:
- 总共发现了134种恶性瘤 (46%),其中TIR3A组为35%,TIR3B组为59%.
- 甲状腺炎是TIR3A结节中恶性瘤相关的统计学显著因素 (p=0.0009).
- 超声波风险分层对于预测TIR3A (p=0.0004) 和TIR3B (p<0.0001) 结节的恶性病具有重要意义.
结论:
- 对于具有不确定的细胞学TIR3A的结节性甲状腺病理,应始终考虑进行手术治疗.
- 由于恶性瘤的高发病率,由于TIR3B分类的未确定的甲状腺结节,手术是强制性的.
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