摘要目的 了解天津地区健康体检人群甲状腺结节和甲状腺癌的分布特征,评价超声诊断在早期发现甲状腺恶性病变中的价值.方法 以参加体检的健康人群作为研究对象,采用超声诊断技术对甲状腺占位性病变进行筛查,并通过超声征象及甲状腺影像报告和数据系统(TI-RADS)对甲状腺结节良恶性进行风险评估,随访1年.结果 5196例体检者中,甲状腺结节阳性2068例,检出率为39.80%.男性和女性健康体检者甲状腺结节检出率分别为35.04%和44.78%,男性甲状腺结节检出率低于女性(P<0.001).检出甲状腺癌18例,检出率为0.35%.男性和女性健康体检者甲状腺癌检出率分别为0.34%和0.36%,差异无统计学意义(P>0.05).甲状腺结节检出率随年龄增长而增加,但检出的甲状腺癌患者主要集中在30~39岁组和50~59岁组.甲状腺癌患者均行手术治疗,以分化较好的甲状腺乳头状癌居多(17例),以早期癌、微小癌为主,复发危险度相对较低.超声TI-RADS诊断甲状腺癌的敏感度为72.22%,特异度为98.94%,准确度为98.85%.结论 天津地区健康体检人群甲状腺结节检出率接近40%,且不同性别和年龄之间存在差异.超声TI-RADS分级在健康体检者甲状腺结节检出和良恶性鉴别中具有一定价值,是一项有效的无创筛查方法.

abstractsObjective To investigate the distribution characteristics of thyroid nodules and thyroid cancer in physical examination population in Tianjin,and report the outcome of ultrasonography in detection of thyroid nodules. Methods Enrolled all of physical examination population in our hospital from Jan 1, 2014 to Dec 31, 2014 as our study subjects then the thyroid gland lesions were screened by ultrasound diagnostic technique. The risk assessment of benign and malignant thyroid nodules was assessed by ultrasonography and thyroid imaging reporting and data system(TI-RADS), and the individuals were followed up for 1 year. Results Among the 5 196 cases,the patients with thyroid nodules was 2 068 cases (39.80%). The thyroid nodules was 35.04% in male and 44.78% in female subjects,lower in females than in male cases(P<0.001). 18 cases of thyroid cancer patients were detected(0.35%). The thyroid cancer rate were 0.34% and 0.36% in male and female respectively(P>0.05).Thyroid nodules increased with age, but the thyroid cancer patients were mainly concentrated in the 30 to 39 years old group and 50 to 59 years old group. All of the thyroid cancer patients underwent surgical treatment, better differentiation thyroid papillary carcinoma(17 cases)in major, most were early stage cancer and micro-cancer, possessing relatively low risk of recurrence. The sensitivity, specificity and accuracy of ultrasonography and TI-RADS diagnosis of thyroid cancer was 72.22%,98.94% and 98.85%. Conclusions The detection rate of thyroid nodules in our population is close to 40%,and there are differences between sexes and ages.Ultrasonography and TI-RADS association is an efficient method to detect the nodules in thyroid.