| Objective: To retrospectively analyze the clinical data of patients diagnosed as NG undergoing concurrent surgery from 1962 to 2019 in the single center clinical medical record system of China-Japan Friendship Hospital of Jilin University,analyze the changing trend of its clinicopathological features,and explore the related factors affecting the choice of treatment measures.Methods: A total of 8918 NG patients with complete information were included in the primary operation.Taking 10 or 5 years as a group,the epidemiological changes of NG were analyzed retrospectively,and the trends and characteristics of each index were described.The frequency and multivariate tests were used to compare and analyze the differences of clinicopathological features in different years,and the continuous variables were tested by T test and Mann-Whitney U test.Classification variables were analyzed by Chi-square test and rank sum test.Binary Logistic regression model was used for correlation analysis.Results:1.The overall change trend of NG in 59 years: 8918 cases of NG operation were performed from 1962 to 2019,and the number of cases increased year by year,but the proportion decreased.2.Trends of age and sex: The average age of patients increased from 32.69 13.10 years in 1962～1969 to 49.13 10.11 years in 2010～2019.Taking the year 2000 as the critical point,NG patients changed from youth to middle age,and NG generally showed aging.The male to female ratio of NG is 1:3.93,which is more common in women,but the operative age of male is older than that of female(44.78±11.48 vs.47.68±12.19).3.Clinicopathological features and changes of NG: From 2000 to 2019,the nodules of NG patients were mixed hypoechoic nodules in Shuang Ye(accounting for68.3% and 48.9% respectively),with clear boundaries(56.4%),and 11.9% of nodules showed calcification,mainly fine calcification(36.6%).Compared with 1962-1999,the proportion of female surgical patients decreased(77.2% vs.82.8%),the average age of surgery increased(48.99±3.34 vs.41.05±5.75),the proportion of hyperthyroidism decreased(4.0% vs.8.4%),and the average maximum diameter of nodules decreased(5 Comparing the pathological changes of paraffin before and after 2000,NG was accompanied by calcification(30.4% vs.0.6%),cystic change(31.0% vs.8.7%),papillary change(12.4% vs.0.0%)and bleeding(26.6% vs.0.1%)from 2000 to 20194.Influencing factors of 4.NG nodule size and multifocal:The second quartile of nodule duration was Q2(OR=1.432,95CI% 1.060～1.911),age(OR=1.063,95CI% 1.052 ～ 1.0.74),and hyperlipidemia(OR = 1.680,95 CI%1.035 ～ 2.5)95CI% 1.628 ～ 7.446)is the risk factor of NG multifocal,while male(OR=0.513,95CI% 0.410 ～ 0.641)and larger nodule(OR=0.831,95CI% 0.785～0.881)are the protective factors of NG multifocal.It was found that the nodules lasted longer(OR=1.005,95CI% 1.004～1.007),TSH decreased(OR=1.612,95CI% 1.032 ～ 2.516),Tg-Ag increased(OR=2.463,95CI% 1.872 ～ 3.241)The decrease of Tg-Ag level(OR=0.397,95CI% 0.193～0.816)and the increase of Anti-Mic Ab(OR=0.470,95CI%0.285 ～ 0.773)are the major protective factors of nodules.Conclusion:1.During 1962-2019,the number of NG operations increased,but the proportion decreased,which mainly occurred in middle-aged people(aged 45 ～ 60 years),mainly women.The average age of operation is increasing year by year,and the age of operation in men is higher than that in women.2.The sonographic features of NG are cystic and solid mixed hypoechoic nodules with clear boundary,and some nodules have calcification,mainly fine calcification.Cystic degeneration,calcification and hemorrhage are the three most common pathological changes associated with NG,while thyroid adenoma is the most common disease associated with NG.3.Compared with 1962～1999,after 2000,the proportion of female surgical patients and patients with hyperthyroidism decreased.NG after 2000 is characterized by multiple,small and nonfunctional nodules.After operation,paraffin pathology combined with calcification,cystic degeneration,papillary degeneration and bleeding increased,and NG pathology showed heterogeneity.4.Age,time of finding nodules,hyperlipidemia,hyperthyroidism and BMI may be risk factors for multiple nodules.Larger nodules and males may be the protective factors of multifocal nodules.It was found that longer nodule time,lower TSH and higher Tg-Ag may be the risk factors of NG nodules.Tg-Ag decrease and Anti-Mic Ab increase may be the protective factors. |
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