A Sampling Investigation Of The Current Diagnosis Status Of Thyroid Cancer In Some Three Level Of First-class Hospitals In Liaoning Province

ObjectiveTo investigate the status of preoperative diagnosis, diagnositic evidences and the application of the auxiliary examinations for the patients, who suffered from thyroid cancer identified with the initial surgery and pathology in the top three hospitals of three level of first-class in Liaoning Province.MethodsThis is a retrospective investigation. We had inspected the records of 629 patients, who visited the three hospitals from Jan 2000 and Dec 2006 were confirmed to thyroid cancer by surgery and pathology.Results1. 629 cases of thyroid cancer were investigated, of which 484 cases only had surgery once . In the 484 cases, papillary thyroid carcinoma was the most common pathological type, with a percentage of 80.37%, follicular carcinoma of 2.07%, Undifferentiated carcinoma of 3.51%, medullary carcinoma of 2.27%, other histological types of 11.78%.2. The application situation of auxiliary examinations for thyroid cancer patients during different stages before surgery:Thyroid ultrasonography accounted for 89.13% to 100%; thyroid fine-needle aspiration cytology (FNAC) accounted for only 10.11% to 20.34 %; 73.91% to 85.37% in patients with preoperative detection of thyroid function. 3. Thyroid ultrasonography, FNAC results and thyroid radionuclide scanning results:(1) The correlation analysis of high-resolution color two-dimensional ultrasonographic features and pathologic results for the thyroid cancer patients confirmed by initial surgery and pathology. Thyroid cancer performance hypoechoic nodules and micro-calcification (with gravel-like calcification) detection rates were 62.07% and 39.66%, and the blood supply of thyroid cancer was characterized by high-resistance. The thyroid cancer patients with enlarged cervical lymph nodes accounted for 50.43 %.(2) In the 64 cases (64/484) who had FNAC results, there are 4 cases (6.25%) couldn't be diagnosed, 25 cases (39.06%) were malignant, 27 cases (42.19%) were uncertainty (new or suspicious biological), 8 cases ( 12.50%) benign,and 8 cases (12.50%) were false-negative.(3) 26.24% (127/484) patients had done the thyroid radionuclide scanning detection before surgery, of whom 73.23% (93/127) had the performance of "cold" nodules and / or "cold" nodules, and 1.51% (2/127) had the performance of "hot" nodules.4. The preoperative diagnostic rate of thyroid cancer was only 13.84%, which were mainly based on FNAC and lymph node biopsy; preoperative suspected thyroid cancer patients accounted for 21.69%, which were mainly based on thyroid ultrasonography (59.05%) and / or FNAC; there were 59.92% patients with a preoperative diagnosis of tumor to be undetermined nature, nodular goiter or thyroid adenoma, which were based on thyroid ultrasonography (84.83%) and / or thyroid radionuclide scanning detection.ConclusionThis investigation found that thyroid ultrasonography is the most commonly used preoperative examination for thyroid cancer patients. Thyroid ultrasonography fings showed the majority thyroid nodules were hypoechoic nodules, micro-calcification (with gravel-like calcification ), nodules with high blood or enlarged cervical lymph nodes for thyroid cancer performance. The application rate of FNAC is lower; preoperative diagnosis rate is low, and the diagnosis is mainly ultrasound-based , and the application of FNAC can improve the preoperative final diagnosis rate of thyroid cancer. The papillary thyroid carcinoma is the most common pathotype of thyroid cancer.