贝塞斯达III和IV甲状腺结节中的恶性病率和预测因素:前性研究
Eman Z Azzam1, Marwa A Salah1, Waleed A Aboelwafa2
1Internal Medicine, University of Alexandria, Alexandria, EGY.
Cureus
|January 31, 2025
概括
这项研究发现,贝塞斯达III和IV甲状腺结节的恶性瘤发病率与已确定的风险一致. 较高的ACR-TIRADS得分和特定的超声波特征可以预测恶性瘤,有助于为甲状腺结节做出手术决定.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
背景情况:
- 甲状腺结节是常见的内分泌异常.
- 精细针吸入细胞学 (FNAC) 使用贝塞斯达系统报告甲状腺细胞病理学 (BSRTC) 分类结节.
- 贝塞斯达类别III和IV由于恶性瘤的风险变化而带来诊断挑战.
研究的目的:
- 通过甲状腺切除术后的组织病理学来评估贝塞斯达III和IV甲状腺结节中的恶性瘤率.
- 为了将美国放射科医生学院的甲状腺图像报告和数据系统 (ACR-TIRADS) 的得分与组织病理学发现相关联.
- 为了确定贝塞斯达III和IV甲状腺结节中恶性瘤的预测因素.
主要方法:
- 对242名接受FNAC治疗的患者进行前性研究.
- 评估包括病史,临床检查,TSH,甲状腺自身抗体和高分辨率超声波 (HRUS) 与ACR-TIRADS评分.
- 贝塞斯达III和IV结节在临床,声波和患者因素的基础上进行了手术治疗.
主要成果:
- 包括17个贝塞斯达III和65个贝塞斯达IV病例;86.6%接受了手术.
- 贝塞斯达III的恶性瘤率为18.2%,贝塞斯达IV的33.3%.
- 在ACR-TIRADS得分4和5显示恶性瘤风险较高. 独立预测因素包括积极的抗TG Abs,辐射暴露,不规则的边界,高于宽的生长,低可热性,化和坚固的一致性.
结论:
- 贝塞斯达III和IV结节的恶性发病率与BSRTC的估计相一致.
- ACR-TIRADS得分为4和5表明恶性瘤风险较高.
- 阳性铁血球蛋白抗体,辐射暴露和特定的超声波特征预测了这些结节中的恶性病变.
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