A Retrospective Analysis Of Thyroid Nodules And A Correlation Study Between Urine Iodine And Thyroid Nodule

Objective：1.Explore the clinical value for patients with general data, clinical man-ifestations and symptoms, laboratory and ultrasound examination to judge the natur-e of thyroid nodules； Screen sensitive indicators for the differential diagnosisof throid nodules.2.Analysis the correlation between the urinary iodine content and thyroidnodules and thyroid dysfunction;Conduct the individual appropriately iodine intakingand avoid the harm caused by excessive iodine intake.Methods：1.we selected2140patients with thyroid nodules who had thyroidectomy andPathology results after operation from January2007to January2012in The secondaffiliated hospital of NanChang University. Retrospect and entry gender, age, diseaseduration, family history, medical history, clinical symptoms, signs, aboratoryparameters ofthyroid function and related antibodies, preoperative ultrasonographydescription result, postoperative histopathologic results of patients. Divide intobenign and malignant two groups according to the pathologic result.Compare andestimate the value of above factors in judging benign and malignant thyroidnodules respectively.2. We select100patients with thyroid nodules or goiters who had confirmedwith supersonic inspection after seeing a doctor from April2011to August2011inour hospital.100cases without thyroid nodules were used to contrast.. Detectionurine iodine content of the200cases and statistic analysis the relevant data of eachgroup.Results：1.(1) Male517cases, female1623cases, the ratio of male and female is1:3.14, the average medical history is3.6months (2days to56years), the averageage is46.6±12.3(14-year-old to78years).1712cases of patients with benignnodules, malignant nodules are428cases.The ratio of benign and malignant is 4:1. Ages of patients with benign nodules range from14to75years (mea-n47.9±13.1years), malignant nodules from20to78years (mean43.3±12.7years), age of the malignant nodules group is less than the benign group (p <0.05);The total number of nodules are3090. Dysphagia, hoarseness, hard texture andpoor activity of nodules,having intumescent cervical lymph node,and previoushistory of thyroid disease respectively were46,34,334,74105,85.There was a signi-ficant difference of the above-mentioned features between benign and malignantnodules (p <0.05).The maximumdiameter of malignant nodules is6*5.2cm (average1.82±1.01cm), andbenignnodules is8.5*11cm (average2.86±1.09cm)(p=0.005).(2)1502cases have thyroid function tests, including1276cases of thyroid functionwas normal,226abnormal cases.The incidence of thyroid dysfunction were15.2%(137/902) and14.8%(89/600)in benign and malignantgroups, there was nosignificant difference(p=0.781); TSH in malignant group (3.46±0.13IU/mL) washigher than the benign group(1.76±0.18IU/mL), there were significant differences(p <0.05).(3) Ultrasonic inspection consider nodular goiter1801cases,thyroidadenoma182cases, thyroid cancer383cases. According to the pathological resultswe came to a conclusion: The concidence rate of nodular goiter is91.2%, thyroidadenoma is83.5%and thyroid cancer74.9%.The total match rate is up to84.5%.The proportion of solid nodules in the malignant group is up to85.6%, mali-gnantratio of nodules containing cystic components was only1.2%, there was a significantdifference(p=0.001) of cystic or cystic primaryily between benign and malignantnodules.(4)Compared with the postoperative pathological changes,the accuracy offine-needle aspiration biopsy in judging suspiciously malignant and malignantnodules respectively were68%and93.9%.2.(1) Urinary iodine average of thyroid nodules group is higher than normal(single nodule212ug/l, multiple nodules320ug/l and normal control group106ug/l)(2) With the elevated levels of urinary iodine, the detection rate of singal thyroidnodule gradually reduced(66.7%-40%), but multiple thyroid nodules graduallyincreased (33.3%-60%). Multiple thyroid nodules are related to the content of Urineiodine(p<0.01).Conclusion： 1. Thyroid nodules occur in older women, and the malignant ones occurin young men;Patients with hoarseness, difficulty swallowing, neck lymph nodes areapt to malignant.2. within the normal range, The higher TSH the higher rate of malignant.3.Nodules of single solid, fuzzy boundaries, the smaller the average diameter, arich and inordinate internal blood supply suggest malignant possibility; Sand-likecalcification in the nodules is highly suggestive of malignant.4.Although the Fine-needle aspiration is invasive, but the damage andcomplications is minor, the rate of diagnosis is extremely high.It is the most effectivediagnostic method of thyroid nodules.5. The incidence of thyroid nodules was positive correlation with iodine level.