The problem of malignancy in nodular goiter: recapitulation and a challenge.
The problem of malignancy in nodular goiter: recapitulation and a challenge.
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结节性甲状腺肿的恶性肿瘤问题：回顾和挑战。
DOI：
10.1001/jama.1959.03010040001001
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发表时间：
1959
影响因子：
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通讯作者：
J. Sokal
中科院分区：
文献类型：
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作者：
J. Sokal
甲状腺癌与无毒结节性甲状腺肿和最初良性甲状腺腺瘤的关系一直是长期和激烈争论的主题。一些作者声称，非常多的无毒结节性甲状腺肿是恶性的，并建议在所有情况下立即甲状腺切除术。这里指出，无毒结节性甲状腺肿是一种相当常见的发现（每百万人中至少有30,000例可触及的甲状腺肿），而甲状腺癌是罕见的（每年每百万人中仅诊断出25例）。有证据表明，手术切除所有结节性甲状腺将导致更多的生命损失，而不是由此导致的甲状腺癌死亡率的降低。今天的重点是甲状腺结节的鉴别诊断，恶性可能性高的应及时手术，否则应保守治疗。
The relation of thyroid cancer to nontoxic nodular goiter and to initially benign thyroid adenomas has been the subject of prolonged and vehement controversy. Some authors have claimed that very many non-toxic nodular goiters are malignant and have recommended immediate thyroidectomy in all cases. It is here pointed out that nontoxic nodular goiter is a fairly common finding (at least 30,000 palpable goiters per million of population) while thyroid cancer is rare (only 25 cases diagnosed per million of population per year). There is evidence that surgical removal of all nodular goiters would result in more loss of life than could be justified by the resultant decrease in mortality from thyroid cancer. Emphasis today should be on the differential diagnosis of the thyroid nodule, with prompt operation in cases where the probability of malignancy is high and conservative treatment otherwise.