SCI REP:1.5-2cm甲状腺癌与远处转移及死亡率无关

2017-04-18 MedSci MedSci原创

随着影像学诊断尤其是高清超声应用的不断增加,越来越多的甲状腺结节被发现。对于这些发现的甲状腺结节,判断其良恶性尤为重要。细针穿刺是诊断甲状腺结节性质的常用工具,其准确度及性价比很高。大部分指南均推荐细针穿刺作为甲状腺结节的诊断工具。2cm以上的甲状腺癌会出现远处转移,因此对于2cm以上的甲状腺结节需细针穿刺活检。而大部分指南均未建议对1cm以下的甲状腺结节进行穿刺细针穿刺检查。

随着影像学诊断尤其是高清超声应用的不断增加,越来越多的甲状腺结节被发现。对于这些发现的甲状腺结节,判断其良恶性尤为重要。细针穿刺是诊断甲状腺结节性质的常用工具,其准确度及性价比很高。大部分指南均推荐细针穿刺作为甲状腺结节的诊断工具。2cm以上的甲状腺癌会出现远处转移,因此对于2cm以上的甲状腺结节需细针穿刺活检。而大部分指南均未建议对1cm以下的甲状腺结节进行穿刺细针穿刺检查。

SCI REP近期发表了一篇文章,研究了1-2cm甲状腺癌是否需要进行细针穿刺检查。作者以1.5cm作为临界值,通过检索SEER数据库共纳入14117例甲状腺癌患者。经过多变量调整之后,作者发现1.5-2cm的甲状腺癌与远处转移无关(OR=1018,P=0.14),与甲状腺癌死亡率无关(SDHR=1.4,P=0.08),与非肿瘤死亡率也无关(SDHR=1.06,P=0.55)。

文章最后得出结论,1.5-2cm的甲状腺癌与1-1.5cm的甲状腺癌相比远处转移及死亡率并无显着差别,可以使用1.5cm作为是否需要进行细针穿刺检查的临界值。当然,这一结论还需进一步以1.5cm作为临界值的细针穿刺检查甲状腺结节的临床研究加以证明。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=192515, encodeId=be05192515b7, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/1A51842815047D40BFDAA8D69AA8E519/100, createdBy=fd7f2029163, createdName=绛珠草小姐, createdTime=Mon May 01 11:15:07 CST 2017, time=2017-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190761, encodeId=faf5190e6143, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/1A51842815047D40BFDAA8D69AA8E519/100, createdBy=fd7f2029163, createdName=绛珠草小姐, createdTime=Wed Apr 26 14:00:36 CST 2017, time=2017-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=189099, encodeId=ae8a18909918, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/fw6ok8nCqUopYb7ic5se0u2gJEA5V2LY4HibTqB00WuXpTaEVwqqicibbKPicjJHT1SdmiaV4SdL9WzuMJHdkcjCyuUg/132, createdBy=30d51625198, createdName=樊银杰, createdTime=Thu Apr 20 16:04:29 CST 2017, time=2017-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423487, encodeId=f78e142348e1f, content=<a href='/topic/show?id=badd9441868' target=_blank style='color:#2F92EE;'>#远处转移#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94418, encryptionId=badd9441868, topicName=远处转移)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c42b3793913, createdName=hanhaisha2009, createdTime=Thu Apr 20 05:24:00 CST 2017, time=2017-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188957, encodeId=90d718895ec3, content=好文,值得点赞,更值得收藏!慢慢领会学习的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Thu Apr 20 04:39:18 CST 2017, time=2017-04-20, status=1, ipAttribution=)]
    2017-05-01 绛珠草小姐

    学习了,谢谢分享

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=192515, encodeId=be05192515b7, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/1A51842815047D40BFDAA8D69AA8E519/100, createdBy=fd7f2029163, createdName=绛珠草小姐, createdTime=Mon May 01 11:15:07 CST 2017, time=2017-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=190761, encodeId=faf5190e6143, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/1A51842815047D40BFDAA8D69AA8E519/100, createdBy=fd7f2029163, createdName=绛珠草小姐, createdTime=Wed Apr 26 14:00:36 CST 2017, time=2017-04-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=189099, encodeId=ae8a18909918, content=不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/fw6ok8nCqUopYb7ic5se0u2gJEA5V2LY4HibTqB00WuXpTaEVwqqicibbKPicjJHT1SdmiaV4SdL9WzuMJHdkcjCyuUg/132, createdBy=30d51625198, createdName=樊银杰, createdTime=Thu Apr 20 16:04:29 CST 2017, time=2017-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423487, encodeId=f78e142348e1f, content=<a href='/topic/show?id=badd9441868' target=_blank style='color:#2F92EE;'>#远处转移#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94418, encryptionId=badd9441868, topicName=远处转移)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c42b3793913, createdName=hanhaisha2009, createdTime=Thu Apr 20 05:24:00 CST 2017, time=2017-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=188957, encodeId=90d718895ec3, content=好文,值得点赞,更值得收藏!慢慢领会学习的。, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Thu Apr 20 04:39:18 CST 2017, time=2017-04-20, status=1, ipAttribution=)]
    2017-04-26 绛珠草小姐

    学习了,谢谢分享

    0

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    2017-04-20 樊银杰

    不错

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    2017-04-20 ylzr123

    好文,值得点赞,更值得收藏!慢慢领会学习的。

    0

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甲状腺癌如何治疗,需要取出甲状腺吗?当使用碘治疗的时候,又是什么原理呢?治疗甲状腺癌通常需要取出全部或者部分甲状腺,当甲状腺癌发展到晚期时,推荐手术后使用碘放射治疗,防止手术中没有清除干净的癌细胞转移。对于非常小的乳头状甲状腺癌 (直径小于 1 厘米, 完全局限于甲状腺超声检查),可以不做手术,只需要定期观察,需要每年使用高清晰的超声波做甲状腺检查,这种小的甲状腺癌一般没有侵略性,尤其是对

JAMA:美国甲状腺腺癌发病与死亡率变化——1974-2013

1974-2013年,在美国被诊断为甲状腺癌的患者中,甲状腺癌的总发病率每年增加3%,中晚期甲状腺乳头状癌的发生率和癌死亡率增加。