Analysis Of144Cases Hashimoto’s Disease With Thyroid Nodules

Objective: Analyzing144cases Hashimoto’s disease with different kinds ofthyroid nodules retrospectively which were confirmed by postoperative paraffinicpathologies. The characteristics of thyroid ultrasound and thyroid CT scan image ofHashimoto’s disease with different kinds of thyroid nodules (inflammatory nodule,thyroid cancer nodule, nodules of nodular goiter) and the positive rate of TGAb andTPOAb in serum were analyzed, which could provide optimized choice of surgicalapproach schedule.Methods: Collecting144cases of Hashimoto’s disease with different kinds ofthyroid nodules which were confirmed by postoperative paraffinic pathologies. All thecases were performed surgery due to thyroid nodule in the general surgery departmentof First Affiliated Hospital of Dalian Medical University from January2011toDecember2012. Inside15cases (group H) were confirmed as Hashimoto’s disease withinflammatory nodules,71cases (group HC) were confirmed as Hashimoto’s diseasewith thyroid cancer, and58cases (group HNG) were confirmed as Hashimoto’s diseaseassociated with nodular goiter. Hollow blood samples were taken from in the morningin order to detect TGAb and TPOAb in serum. All of144cases were checked by thyroidcolor Doppler ultrasound or thyroid CT scan. In group H,13cases were checked byultrasound and7cases were checked by CT scan. In group HC,60cases were checkedby ultrasound and34cases were checked by CT scan.In group HNG,54cases werechecked by ultrasound and22cases were checked by CT scan.According to derived statistic, each preoperative color Doppler ultrasound and CTscan results and the difference between the positive rates of TGAb and TPOAb in serumwere collected and analyzed.Results:1. The results of Hashimoto’s disease with inflammatory nodules (groupH) and Hashimoto’s disease with thyroid cancer thyroid (group HC) color Dopplerultrasound examination: The numbers of cases of nodules with calcification are3(23.07%) in group H and46(76.66%) in group HC (p <.01); The numbers of cases of nodules withmicro-calcification are0(0%) in group H and20(30.00%) in group HC (p <.01); Thenumbers of cases of solid nodules with diffuse lesion are9(69.23%) in group H and58(96.66%) in group HC (p <.01); The numbers of cases of nodules which blood flowincreases in internal and peripheral are3(23.07%) in group H and37(59.67%) in groupHC (p <.01).2. The results of Hashimoto’s disease with inflammatory nodules (group H) andHashimoto’s disease with nodular goiter (group HNG) color Doppler ultrasoundexamination:The numbers of cases of nodules with unclear boundaries are10(54.61%) in groupH and23(42.59%)in group HC (p <.05); The numbers of cases of solid nodules withcystic nodules are0(0%) in group H and31(57.40%) in group HC (p <.01); Thenumbers of cases of mixed nodules are1(7.69%) in group H and19(35.18%) in groupHC (p <.01); The numbers of cases of nodules which blood flow decreases in internaland peripheral are3(23.07%) in group H and29(53.70%) in group HC (p <.05); Thenumbers of cases of nodules uneven internal echo are4(30.76%) in group H and33(61.11%) in group HC (p <.05).3. The results of Hashimoto’s disease with inflammatory nodules (group H) andHashimoto’s disease with thyroid cancer (group HC); Hashimoto’s disease withinflammatory nodules (group H) and Hashimoto’s disease with nodular goiter (groupHNG) thyroid CT examination:The numbers of cases which are in line with typical Hashimoto’s disease CT imageperformance are3(42.86%) in group H; The numbers of cases which are in line withtypical cancer thyroid CT image performance are23(67.65%) in group HC; Thenumbers of cases which are in line with typical nodular goiter CT image performanceare15(68.18%) in group HNG. The data of group H can not be comparised with theother two groups in statistics, in view of the numbers of cases which accept thyroid CTscan in group H are too few.4. The results of Hashimoto’s disease with inflammatory nodules (group H) andHashimoto’s disease with thyroid cancer (group HC); Hashimoto’s disease withinflammatory nodules (group H) and Hashimoto’s disease with nodular goiter (groupHNG) in serum TGAb and TPOAb: The numbers of cases of increased TPOAb and TGAb are15(100%) and11(73.33%) in group H; The numbers of cases of increased TPOAb and TGAb are48(67.60%) and59(83.09%) in group HC; The numbers of cases of increased TPOAband TGAb are44(75.86%) and48(82.75%) in group HNG.. No significant statisticaldifference is found between group H and group HC with the results of serum TGAb andTPOAb, so group H and group HNG do.The numbers of cases of increased TPOAb and TGAb are107of144(the positiverate of74.30%) and118of144(the positive rate of81.94%).Conclusion:1.The ultrasound of Hashimoto’s disease with thyroid cancerperforms as solid nodules with diffuse lesion, the blood flow of nodules inside andaround increasing, shape ill-defined nodules and calcification, especially in the presenceof that micro-calcifications is more meaningful.2. The ultrasound of Hashimoto’s disease associated with nodular goiter performsas solid nodules with cystic nodules or mixed nodules in the context of the diffuselesion, the blood flow of nodules inside and around reduced, the nodules boundariesunclear and nodular uneven internal echo.3. The thyroid ultrasound for the identification of Hashimoto’s disease withdifferent kinds of thyroid nodules is superior to thyroid CT scan, but the thyroid CTscan has a unique advantage over the relationship between thyroid and the surroundingtissue, understanding of thyroid nodules infringed trachea or esophagus if there is a shiftor compression performance.4. Though the examination of serum TPOAb and TGAb for the diagnosis ofHashimoto’s disease is the important clinical implication, not at the level of antibodiesto distinguish between the nature of Hashimoto’s disease with thyroid nodules.5. Nearly half of patients with thyroid nodules in Hashimoto’s disease have thyroidcancers in this group.