【摘要】 甲状腺结节是常见的疾病,但5%的甲状腺结节为恶性肿瘤。临床上对迅速长大的甲状腺结节,有头颈部放射性照射病史、年龄<30岁或>60岁、有多发性内分泌肿瘤2型(MEN2)和甲状腺髓样癌(MTC)家族史、合并淋巴结病变、有侵入或压迫症状、声带麻痹、甲状腺结节固定、肺部转移灶或甲状腺囊性病变复发者应高度关注,尤为男性患者。细针穿刺细胞学检查是甲状腺结节确诊的关键,凡疑有甲状腺结节恶变者应行手术治疗。超声检查在评估甲状腺结节大小、位置、数量以及引导细针穿刺细胞学检查上均有重要作用。降钙素和RET原癌基因系突变的检测只对MTC有意义。而甲状腺球蛋白、甲状腺球蛋白抗体及其他抗甲状腺自身抗体的测定对恶性甲状腺结节鉴别没有意义。更多还原

【Abstract】 The thyroid nodule is a common disease,and 1 in 20 is malignant.Risk factors of the disease include rapid growth or sudden change in size of a thyroid nodule,exposure to radiation,male gender,age younger than 20 or older than 60 years,family history of type 2 multiple endocrine neoplasia(MEN 2),familial medullary thyroid carcinoma(MTC).Other risk factors include lymphadenopathy and signs of invasion or compression,such as vocal cord paresis or fixation of the nodule.The presence of pulmonary metastases or recurrence of a cystic nodule is also suggestive of malignancy.Fine-needle aspiration cytology is essential to the stratification of cancer risk,and surgery is necessitated for any patient suspected of malignancy.Ultrasonography plays an important role in assessing the size,location and number of nodules,as well as in guiding fine-needle aspiration cytology.The determination of serum calcitonin levels and Germline mutations in the RET protooncogene is of meaning only for the diagnosis of MTC,and the detection of thyroglobulin,anti-thyroglobulin antibodies and other anti-thyroid antibodies has no diagnostic value in the differention of malignant thyroid nodules.更多还原