无症状人群甲状腺超声检查结果流行病学研究

通过对大样本健康体检人群进行甲状腺超声检查，探讨甲状腺结节及甲状腺癌的发生率、分布范围及其发病特点，以期为甲状腺癌的流行趋势及病因研究提供线索。 方法：选取2009年1月~2011年12月北京协和医院健康医学部健康体检者19 895例行甲状腺超声检查，分析甲状腺结节的发病率及发病特点，对高度怀疑甲状腺癌者建议FNA或手术切除，分析甲状腺癌的发病情况。 结果：甲状腺结节的人群发病率为42.6%，其中男性40.0%，女性46.5%；结节发病率随着年龄的增长而明显增高；各年龄段外科触诊结节发病率明显低于超声检查；甲状腺结节的人群中，其中61.3%为多发结节，38.7%为单发结节，男、女性人群中均以多发结节为主。 在单发结节患者中有29例为恶性结节，多发结节患者中有30例为恶性结节，无统计学差异；本组人群甲状腺癌的发病率为0.30%，男性为0.15%，女性为0.50%，发病率最高的为女性的30～40岁的年龄段，发病率为0.76%；甲状腺结节的发生率与年龄、收缩压、身高以及体重有相关性，年龄越大，收缩压越高，结节发生率越高，而身高越低、体重越轻，结节发生率越高，具有显著性差异；与舒张压及体重指数无明显的相关性。 结论：甲状腺癌在人群中的发病率明显增高，女性尤为明显,需有针对性地采取预防措施。定期健康查体，发现结节后及时干预治疗，对控制甲状腺癌的发病和流行具有重要意义。

Epidemiological Study on Thyroid Nodules by Ultrasound in Asymptomatic Subjects

Objective The purpose of this study is to conduct thyroid ultrasound examination on large sample subjects and explore the occurrence, distribution and characteristics of thyroid nodule and thyroid cancer, so as to provide some evidences on epidemic trend of thyroid nodule and cancer. Methods The thyroid ultrasonic examination results of a total of 19895 healthy physical examinees who visited Department of Health Management, Peking Union Medical College Hospital from January 2009 to December 2011 were selected retrospectively to analyze the incidence and characteristics of thyroid nodules. Fine needle aspiration (FNA) or surgical resection was suggested to the subjects who were highly suspected to have thyroid cancer. Results The incidence of thyroid nodules was 42.6%, 40.0% of men and 46.5% of women respectively; The incidence noticeably increases with increasing age; the prevalence of thyroid nodules by palpation was obviously lower than by ultrasonic examination in various age groups. Among those with thyroid nodules, 61.3% were with numerous nodules and 38.7% were with solitary nodule; Numerous nodules were the majority type both in men and women. 29 cases of malignant nodules were found in the subjects with solitary nodule, and 30 cases of malignant nodules in the subjects with numerous nodules. There were no significant differences. The incidence of thyroid cancer was 0.30% the entire group of examinees, and 0.15% in men and 0.50% in women. Among all sex and age groups, 30 to 40 years old women group had the highest incidence of 0.76%. The incidence of thyroid nodules was correlated with age, systolic pressure, height and weight. Increasing age and/or higher systolic pressure led to higher incidence, while smaller height and weight indicated a higher incidence with significant differences. But there were no significant correlations with the incidence and diastolic pressure or body mass index (BMI). Conclusions The incidence of thyroid cancer was on distinct increase among people, especially in women, thus precautions needed to be taken accordingly. Regular physical examination and timely intervention treatment after detection of malignant nodules were critical to curtail the incidence and prevalence of thyroid cancer.