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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。
Thyroid nodules are common diseases, but 5% of thyroid nodules are malignant tumors. Clinically, patients with rapidly growing thyroid nodules have a history of head and neck radiation exposure, with a family history of multiple endocrine neoplasia type 2 (MEN2) and medullary thyroid carcinoma (MTC), age <30 or> 60 years old, Lymphadenopathy, invasion or compression symptoms, vocal cord paralysis, thyroid nodules, lung metastases or thyroid cystic lesions should be highly concerned about the recurrence, especially in male patients. Fine needle aspiration cytology is the key to the diagnosis of thyroid nodules, who suspected thyroid nodules should be treated with surgical treatment. Ultrasonography plays an important role in assessing thyroid nodule size, location, quantity, and guiding fine needle aspiration cytology. Detection of calcitonin and RET proto-oncogene mutations is only meaningful for MTC. The thyroglobulin, thyroglobulin antibodies and other anti-thyroid autoantibodies in malignant thyroid nodules identification no significance.