甲状腺结节伴钙化与甲状腺癌

近年来甲状腺癌的发病率明显上升,随着高频超声检查的广泛应用,甲状腺结节伴钙化与甲状腺癌的关系日益得到重视。甲状腺结节伴钙化既可见于良性甲状腺疾病,亦可见于甲状腺癌,但后者更为常见。在各种类型的钙化中,微钙化与甲状腺癌,特别是甲状腺乳头状癌的关系最为密切,而且微钙化被认为是超声检查诊断甲状腺癌的特异性指标之一。甲状腺癌结节伴钙化,尤其是微钙化的机制目前尚未完全明确。对甲状腺结节伴钙化的诊断受超声仪器,探头频率及操作者的影响。虽然超声检查诊断对甲状腺癌特异性高,发现甲状腺结节伴钙化时,需结合其他参数才能提高诊断的准确性,必要时行细针穿刺活检。

Thyroid nodule with calcification and thyroid cancer

The incidence of thyroid cancer has been noticeably increasing in recent years. With the widespread use of high-frequency ultrasound and in-depth research on thyroid calcification, a close association has been demonstrated between calcification and thyroid cancer. Thyroid calcification can occur in both benign and malignant thyroid diseases, but a higher percentage of nodules complicated by calcification has been described in thyroid cancer compared with benign nodules, and the specificity of microcalcification on ultrasound for malignancy is high. Of the various forms of calcification, microcalcification seems to be most closely correlated with thyroid cancer, especially papillary cancer, and is therefore regarded as a specific marker of malignancy. It is not fully understood why thyroid cancer is often complicated by calcification, and in particular microcalcification. Furthermore, the results of diagnosis may be affected by the quality of the ultrasound equipment used, the transducer frequency, and whether ultrasound interpretation is based on static or real-time imaging. No single ultrasound feature is adequately sensitive to identification of all malignant thyroid nodules, indicating the need for fine-needle aspiration.