Clinical Analysis Of Occult Thyroid Nodules

Objective Explore the clinical examine and choices of surgical treatment of occult thyroidnodules to improve the diagnosis and treatment.Methods A retrospective analysis of Affiliated hospital of NingXia Medical University of338Patients with occult thyroid nodules treated Between October,2009to September,2011in our hospital.Use SPSS17.0to statistical analysis.Results In all338patients,185patients is thyroid carcinoma,the others is benignlesions.all patient had B ultrasound examination,which found that157case of thyroidmicrocacinoma and71case the large size thyroid carcinoma. The sonographic features suchas Solid boundary unclear calcification is dangerous risk that could prompt the thyroidnodules malignant.(P＜0.05）. All patents take the TSH determination.Patients with knownthyroid disease including hyperthyroidism hypothyroidism thyroiditis and those takingthyroxine or previous thyroid surgery that can affcet the seurm thyrotropin concentrationswere not included. There was a positive trend among the benign thyroid nodules PTMC anddifferentiated thyroid cancer(DTC) of larger size(diameter>10mm) However, the TSH levelswere significantly different only between the group with benign lesions and patients withdifferentiated thyroid cancer of larger size (P=0.007). In patients with PTMCs,the mean TSHconcentration in diameter≤5mm was significantly higher than that in patients with diameter>5mm[1.73±1.39mIU/L with1.17±0.76mIU/L，P=0.032]．7out of119patients of thyroidmicrocarcinoma didn’t do intraoperative frozen-section examination,which because these7patients did their second operations and were not influenced by the operation way. There were136microcarcinoma nodules were detected in the ramainder112patients, which120microcarcinoma（120/136） nodules were accordance with intraoperative and postoperative diagonosis and the accuracy was88.2%.9out of136patients were miss diagnosis ormisdiagnosis and7out of136patients were delayed diagnosis. A total119patients of thyroidmicrocarcinoma were treated by surgical operations,of which23patients（19.3%） weretreated by total thyroidectomy,81patients（68.0%）by thyroid gland inferior total excisionsurgery and35patients（29.4%） were treated by central neck dissection neck dissection.Conclusion1.High frequency ultrasound was the first noninvasive choice for ccult thyroidnodules.And the more sensitive imagination features of ultrasonography for thyroidmicrocarcinoma were unclear borderline and accompanied microcalcifications.2.Within thediagnosis of ccult thyroid nodules,serum TSH level still couldn’t be the lonely predictiveindex to evalue the malignant risk of thyroid nodules.3. Frozen section is important to thediagnosis and surgical of thyroid microcarcinoma.4.The minimum resection for unilateralthyroid microcarcinoma was unilateral gland+thyroid isthmus excision and do central neckdissection together.