Retrospective epidemiological study of thyroid nodules by ultrasound in asymptomatic subjects / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The purpose of this study was to conduct thyroid ultrasound examinations on a large sample of subjects and explore the occurrence, distribution, and characteristics of thyroid nodules and thyroid cancer to provide some information on the epidemic trend of thyroid nodules and cancer.</p><p><b>METHODS</b>The thyroid ultrasonic examination results of 19 895 healthy physical examinees who visited the Department of Health Management, Peking Union Medical College Hospital from January 2009 to December 2011 were analyzed retrospectively to determine the detection rate and characteristics of thyroid nodules. Fine needle aspiration or surgical resection was suggested to subjects suspected of having thyroid cancer.</p><p><b>RESULTS</b>The detection rate of thyroid nodules was 42.6% (8 480/19 895), 40.0% (4 661/11 678) in men and 46.5% (3 819/8 217) in women. The detection rate noticeably increased with increasing age. The detection rate of thyroid nodules by palpation was obviously lower than by ultrasonic examination in various age groups. Among those with thyroid nodules, 61.3% were multiple and 38.7% were solitary; multiple nodule was the major type both in men and women. Twenty-nine cases of malignant nodules were solitary, and 30 cases of malignant nodules were multiple. There was no significant difference. The detection rate of thyroid cancer was 0.30% for the entire group of examinees, and 0.15% in men and 0.50% in women. Among all sex and age groups, 30- to 40-year-old women had the highest detection rate (0.76%). The detection rate of thyroid nodules correlated with age, systolic blood pressure, height, and weight. Increasing age and/or higher systolic blood pressure correlated with a higher detection rate, while smaller height and weight also correlated with a higher detection rate with significant differences. However, there were no significant correlations between the detection rate and diastolic blood pressure or body mass index.</p><p><b>CONCLUSIONS</b>The detection of thyroid cancer increased significantly, especially in women. Thus, precautions needed to be taken. Regular physical examination and timely intervention after detection of malignant nodules are critical to improve the prognosis in thyroid cancer patients.</p>

Thyroidnodule scanning by using ultrasonography during health check-up / 中华健康管理学杂志

Objective To study the effectiveness of ultrasonography in thyroidnodule disease detection and malignant/benign lesion differentiation during health check-up.Method Thyroid examination data of Peking Union Medical College Hospital(PUMCH)staff over the last 6 years were retrospectively reviewed.The results of thyroidnodule scanning by using ultrasonography were compared with the findings of physical examinations.Results Among 6348 health check-up receivers from 2006 to 2010,450 were found to have thyroidnodule(detection rate 7.09％).Twenty malignant lesions were confirmed in histological examinations(mean detection rate per year 0.38％).In 2011,1706 thyroid glands were scanned by both physical examination and ultrasonography,and 525 thyroidnodules were identified(detection rate 30.77％).Surgical operations were performed for 22 suspected malignant tumors,and 18 malignant lesions were finally confirmed(detection rate 1.06％).Conclusion Ultrasonography can improve the detection of thyroidnodule.Irregular shape,microcalcification,and rich blood-flow may indicate malignant nodules.

The role of experience in physical examination for early detection of breast cancer / 中华健康管理学杂志

Objective To highlight the role of physician's experience in physical examination for the early diagnosis of breast cancer.Methods Data of physical examination of mammary glands in 1785 female were analyzed and compare with the uhrasonography and mammngraphy results.Results Of the 31 breast cancers confirmed by pathologic examination after operation,2 cases were bilateral breast cancers and 1 was nonpalpable.9 of 41 cases which suspected by inspection were confirmed as breast cancers.The significant difference was found comparing with control group by X2 test (X2=100.5,P＜0.05).The 34 breast cancers were found in 2089 focus in palpation and there were 6 minimal cancers (diameter≤1.0 cm) among them.Some cancers were found in special location with no malignant clinical manifestation.The rate of missed diagnosis of ultrasonography and rnammography is 16.1% and 19.4%,respectively.Conclusions Physical examination plays an important role in the early detection of breast cancer and physician's experience is a major determinant for avoiding misdiagnosis.