The clinical value of ultrasound diagnosis on papillary thyroid carcinoma coexisted with Hashimoto thyroiditis / 中国医师进修杂志

ABSTRACT

ObjectiveTo investigate the diagnostic value of ultrasound on patients with papillary thyroid carcinoma(PTC) coexisted with Hashimoto thyroiditis(HT).Methods The preoperative ultrasonography data of 2144 cases with PTC from January 2006 to December 2011 who treated with operation and diagnosed by pathology were analyzed retrospectively.Among them,265 cases coexisted with HT (PTC coexisted with HT group),1879 cases were not coexisted with HT (non-PTC coexisted with HT group).ResultsMost of the cancerous nodes in two groups exhibited in the ultrasonographic performance just like irregular shape,unclear boundary and so on (P ＞ 0.05).Most of the cancerous nodes in non-PTC coexisted with HT group exhibited hypoechoic nodules with microcalcifications,those in PTC coexisted with HT group exhibited various internal echoes with mainly microcalcifications,and the coarse calcification occupied a certain proportion(P＜ 0.01 ).The cancerous nodes in PTC coexisted with HT group were not rich in blood flow compared with non-PTC coexisted with HT group,but mostly exhibited blood disorders.When compared with non-PTC coexisted with HT group,the rate of ultrasound diagnosis in PTC coexisted with HT group was lower [ 52.8 ％( 140/265 ) vs.75.0 ％ (1409/1879),P ＜ 0.01 ],and the false positive rate in lymph node was higher [84.0％(487/580) vs.74.8％ (77/103)] (P ＜0.05).ConclusionsThe nodules are malignant when they appear as hypoechoic solid nodules,have unclear boundary and have microcalcifications should be highly suspected.The hyperechoic solid nodules or coarse calcification nodules should also be awared and taken further observation of the characteristics around the echoes and the internal blood flow,making comprehensive analysis to determine whether it could be malignant transformation and try best to reduce the misdiagnosis and missed diagnosis rates of this disease.