目的：探讨良恶性甲状腺结节的临床与影像学特征，为临床治疗提供依据。方法采用单中心回顾性研究方法分析2001年1月—2014年2月中国人民解放军空军总医院住院及门诊900例甲状腺结节术后患者的资料，依据病理结果分为甲状腺癌组198例（22.0％），甲状腺良性结节组702例（78.0％）。比较两组患者一般临床资料、甲状腺超声、甲状腺功能七项〔甲状腺球蛋白抗体（ TgAb ）、甲状腺过氧化物酶抗体（ TPO -Ab ）、促甲状腺激素（ TSH）、游离三碘甲状腺原氨酸（ FT3）、游离甲状腺素（ FT4）、三碘甲状腺原氨酸（ TT3）、甲状腺素（ TT4）〕等方面的特征。结果两组患者年龄、进行性增大症状发生率比较，差异有统计学意义（ P＜0.05）。两组边界欠清晰、形态欠规则、结节性质、回声、结节直径比较，差异有统计学意义（ P＜0.05）。甲状腺癌组实性结节比例、低回声结节比例、结节直径≤1 cm 比例高于甲状腺良性结节组（χ2＝279.606、93.215、57.189， P ＜0.05）。两组 TgAb、TPO-Ab阳性率及TSH、 TT4水平比较，差异有统计学意义（ P＜0.05）；两组FT3、 FT4、 TT3水平比较，差异无统计学意义（P＞0.05）。结论甲状腺超声提示边界欠清晰、形态欠规则、实性结节、低回声，甲状腺功能提示TSH水平、 TgAb阳性率、 TPO-Ab阳性率较高的甲状腺结节恶性可能性大，应高度关注。%Objective To explore the clinical and imaging features of benign and malignant thyroid lesions, to provide the basis for clinical work.Methods A total of 900 outpatients and inpatients who received thyroid nodule surgical treatment in Air Force General Hospital, PLA from January 2001 to February 2014, were selected as study subjects, the data of them were analyzed using single center retrospective analysis method.The cases were divided into thyroid carcinoma group ( 198 cases, 22.0%) and thyroid benign lesion group ( 702 cases, 78.0%) according to the pathology results.Characteristics of clinical data, thyroid ultrasound, thyroid function including thyroid globulin anti -body ( TgAb ) , thyroid peroxidase anti -body ( TPO-Ab) , thyroid stimulating hormone ( TSH ) , free triiodothyronine ( FT3 ) , free thyroxine ( FT4 ) , triiodothyronine ( TT3 ) , thyroxine ( TT4 ) were compared between two groups.Results There were significant differences in age and symptoms of progressive enlargement between two groups of patients (P <0.05).There were significant differences in boundary, shape, nature, echo and size of nodule between two groups ( P<0.05 ) .The prevalence of solid nodules, prevalence of hypoechoic nodules, prevalence of nodules 1 cm or smaller in diameter in thyroid carcinoma group was significantly higher than that in thyroid benign lesion group, respectively (χ2 =279.606, 93.215, 57.189, respectively, P <0.05 ) .There were significant differences in the positive rate of TgAb, the positive rate of TPO-Ab, levels of TSH and TT4 between two groups (P<0.05). There was no significant difference in levels of FT3 , FT4 and TT3 between two groups ( P>0.05 ) .Conclusion The nodules with less clear boundary and with irregular shape, solid nodules, nodules with low echo according to thyroid ultrasound findings, and nodules with higher TSH, TgAb, TPO -Ab positive rate are more likely to be malignant, they should be paied more attention.
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