Evaluating the degree of conformity of papillary carcinoma and follicular carcinoma to the reported ultrasonographic findings of malignant thyroid tumor
Evaluating the degree of conformity of papillary carcinoma and follicular carcinoma to the reported ultrasonographic findings of malignant thyroid tumor
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DOI：
10.3348/kjr.2007.8.3.192
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发表时间：
2007-05-01
影响因子：
4.8
通讯作者：
Lee, Yoen Soo
中科院分区：
文献类型：
--
作者：
Jeh, Su-Kyoung;Jung, So Kyung;Lee, Yoen Soo
目的：评估乳头状癌和滤泡癌与已报道的甲状腺恶性肿瘤超声检查结果的符合程度。 材料与方法：2003年1月至2004年12月，对1036例可触及和不可触及的甲状腺病灶患者进行细针抽吸活检。我们回顾性分析了经手术或细针抽吸活检证实的乳头状癌（n = 127）和滤泡状癌（n = 23）患者的超声检查结果。我们根据报道的甲状腺恶性肿瘤超声检查结果分析了这些结节的超声检查结果：低回声、方向高于宽、微分叶或不规则边缘、厚的低回声边缘（晕征）、微钙化和囊性改变。结果：72.4%（92/127）的乳头状癌回声为低回声，65.2%为等回声。 (15/23) 滤泡性癌 (p < 0.001)。 74.1% 的乳头状癌结节形状为高或圆形，但 72.7% 的滤泡状癌结节形状为扁平 (p < 0.001)。 92.9% 的乳头状癌和 60.9% 的滤泡状癌的肿瘤边缘呈微分叶状或不规则 (p < 0.001)。低回声边缘见于 26% 的乳头状癌（薄边缘：13.4%，厚边缘：12.6%）和 86.6% 的滤泡状癌（薄边缘：39.1%，厚边缘：47.8%，p < 0.001）。 33.9% 的乳头状癌中显示有微钙化，而滤泡性癌中没有出现微钙化（p < 0.001）。 98.4%的乳头状癌和82.6%的滤泡状癌可见实性肿块，无囊性变（p < 0.001）。结论：既往报道的甲状腺恶性肿瘤的超声检查结果与大多数乳头状癌一致，但与滤泡状癌不符。应谨慎应用目前甲状腺恶性肿瘤的超声检查特征作为针吸活检的指征，以免因过于狭窄和严格的活检标准而漏掉滤泡性癌。
Objective: We wanted to evaluate the degree of conformity of papillary carcinoma and follicular carcinoma to the reported ultrasonographic findings of malignant thyroid tumor.Materials and Methods: Between January 2003 and December 2004, fine needle aspiration biopsy was performed in 1,036 patients with palpable and non-palpable thyroid lesions. We retrospectively reviewed the ultrasonographic findings of patients with papillary carcinomas (n = 127) and follicular carcinomas (n = 23) that were proven by operation or fine needle aspiration biopsy. We analyzed the ultrasonographic findings of these nodules based on the reported ultrasonographic findings of malignant thyroid tumor: hypoechogenicity, a taller than wide orientation, a microlobulated or irregular margin, a thick hypoechoic rim (halo sign), microcalcification and cystic Change.Results: The echogenicity was hypoechoic in 72.4% (92/127) of the papillary carcinomas, but it was isoechoic in 65.2% (15/23) of the follicular carcinomas (p < 0.001). The nodule shape was tall or round in 74.1% of the papillary carcinomas, but it was flat in 72.7% of the follicular carcinomas (p < 0.001). The tumor margin was microlobulated or irregular in 92.9% of the papillary carcinomas and in 60.9% of the follicular carcinomas (p < 0.001). A hypoechoic rim was seen in 26% of the papillary carcinomas (thin rim: 13.4%, thick rim: 12.6%) and in 86.6% of the follicular carcinomas (thin rim: 39.1%, thick rim: 47.8%, p < 0.001). Microcalcifications were demonstrated in 33.9% of the papillary carcinomas and in none of the cases of follicular carcinoma (p < 0.001). A solid mass without cystic change were seen in 98.4% of the papillary carcinomas and in 82.6% of the follicular carcinomas (p < 0.001).Conclusion: The previously reported ultrasonography findings of malignant thyroid tumor are in conformity with most of the papillary carcinomas, but not with follicular carcinomas. The current ultrasonographic features for thyroid malignancy should be cautiously applied as the indication for needle aspiration biopsy so that follicular carcinomas are not missed by too narrow and strict biopsy criteria.