Dab tsi ntxiv tuaj yeem ua kom pom cov thyroid nodules?

1) Kev kuaj mob qog noj ntshav: cov thyroid hormone (T3, T4, FT3, FT4) thiab cov tshuaj ntsuam xyuas TSH yuav tsum tau ua rau txhua tus neeg mob uas muaj cov thyroid nodules kom paub seb puas muaj hyperthyroidism lossis hypothyroidism. Feem ntau ntawm cov neeg mob uas muaj cov thyroid malignancy muaj cov thyroid ua haujlwm. TSH suppression ntawm cov thyroid nodules qhia tias cov nodules yuav ua haujlwm nodules. Cov thyroid radionuclide imaging yog xav tau los xyuas kom meej qhov kev kuaj mob.

(2) Kev kuaj mob thyroid autoantibody: Serum TPOAb thiab TGAb qib kuaj pom muaj txiaj ntsig zoo rau kev kuaj mob Hashimoto's thyroiditis, tshwj xeeb tshaj yog rau cov neeg muaj ntshav siab TSH qib. Serum anti-thyroid antibody qib tau nce siab hauv ntau dua 85 feem pua ​​​​ntawm Hashimoto cov neeg mob thyroiditis. Txawm li cas los xij, kev kuaj mob ntawm Hashimoto's thyroiditis tsis tuaj yeem tshem tawm tag nrho cov thyroid malignancy. Qee tus Hashimoto cov thyroiditis tuaj yeem cuam tshuam nrog papillary thyroid carcinoma lossis thyroid lymphoma.

(3) Kev txiav txim siab ntawm cov thyroid globulin (Tg) qib: thyroid o lossis qog tuaj yeem ua rau nce qib Tg ntshav. Kev txiav txim siab ua ntej ntawm cov thyroid Tg tsis tuaj yeem paub qhov zoo ntawm cov thyroid nodules. Kev ntsuas qib ntshav Tg feem ntau yog siv los txiav txim siab rov tshwm sim thiab metastasis ntawm cov qog nqaij hlav qog noj ntshav tom qab tag nrho lossis ze rau tag nrho cov kev txiav tawm thiab / lossis tshem tawm cov thyroid seem los ntawm radioiodine.

(4) Kev txiav txim siab ntawm qib calcitonin hauv cov ntshav: medullary thyroid carcinoma tuaj yeem kuaj tau thaum cov thyroid nodules nrog los ntawm qib calcitonin nce siab. Hauv cov tib neeg uas muaj keeb kwm ntawm tsev neeg ntawm medullary thyroid carcinoma los yog ntau yam endocrine adenomas, ntshav calcitonin qib yuav tsum tau kuaj rau basal lossis stimulated medullary thyroid carcinoma.

(5) Kev tshuaj xyuas thyroid ultrasound: Tam sim no, thyroid ultrasound kuaj yog txoj kev rhiab tshaj plaws los ntsuas qhov loj thiab tus naj npawb ntawm cov thyroid nodules. Nws yog tsuas yog siv los txiav txim qhov muaj thiab tus naj npawb ntawm cov thyroid nodules, qhov loj thiab qhov ntawm nodules, muaj thiab tsis muaj lub ncauj tsev menyuam qog nqaij hlav, thiab pab cov thyroid puncture positioning, kev kho mob thiab kev soj ntsuam.

Txhua tus neeg mob uas xav tias yog cov thyroid nodules uas twb muaj lawm yuav tsum tau mus kuaj thyroid ultrasound. Yog tias cov yam ntxwv hauv qab no pom ntawm cov thyroid ultrasound, feem ntau qhia tau hais tias cov nodules feem ntau yuav ua rau malignant. ① Tsis tshua muaj suab nrov; ② Nodular npoo yog tsis xwm yeem; ③ Spotty calcification hauv nodules; (4) cov ntshav khiav tsis zoo hauv cov nodules; ⑤ Cov qog nqaij hlav o hauv caj dab.

Tsis tas li ntawd, cov benign thiab malignant nodules tsis muaj dab tsi ua nrog qhov loj ntawm nodules. Malignancy tsis tshua muaj tshwm sim hauv cov nodules tsawg dua 1.0 cm inch. Tsis hais txog seb cov nodules puas palpable; Nws tsis cuam tshuam rau ib leeg lossis ntau qhov nodules; Cov nodules tsis cuam tshuam nrog cystic hloov.

(6) Thyroid nuclide imaging: thyroid nuclide imaging yog tib txoj kev ntsuas uas tuaj yeem ntsuas qhov ua haujlwm ntawm cov thyroid nodules tam sim no. Nodules tau muab faib ua "kub nodules", "sov nodules" thiab "txias nodules" raws li lawv lub peev xwm uptake ntawm radionuclides. "Kub nodules" yuav luag benign, thiab malignant lesions yog tsawg heev. "Sov nodules" thiab "txias nodules" yog malignant. Yog li ntawd, cov thyroid nuclide imaging tsuas yog muaj qhov tseem ceeb rau kev kuaj mob rau "kub nodules", thiab yog ib qho kev pab me me los txiav txim seb qhov benign thiab malignant thyroid nodules. Nws yog tsim rau cov neeg mob uas muaj cov thyroid nodules ua ke nrog hyperthyroidism thiab subclinical hyperthyroidism.

(7) Kev kuaj mob ntawm cov thyroid magnetic resonance MRI thiab CT: MRI lossis CT yog qhov muaj txiaj ntsig zoo los txiav txim siab qhov muaj lossis tsis muaj cov thyroid nodules, thiab nws qhov rhiab heev yog tsawg dua li cov thyroid ultrasound, thiab nws kim heev. Yog li ntawd, thawj daim tshev tsis pom zoo. Txawm li cas los xij, MRI lossis CT tuaj yeem txiav txim siab txog kev sib raug zoo ntawm cov thyroid nodules thiab cov ntaub so ntswg ib puag ncig, seb puas muaj cov thyroid retrosternal, seb puas muaj mediastinal lymph node metastasis, thiab lwm yam. MRI lossis CT kuaj tau ua tau thaum nkag siab txog kev sib raug zoo ntawm cov thyroid nodule thiab ib puag ncig cov ntaub so ntswg thiab seb puas muaj cov thyroid nodules. muaj mediastinal lymphatic metastasis.

(8) Thyroid fine needle aspiration cytology biopsy (FNAC): FNAC yog qhov tseeb tshaj plaws, txhim khu kev qha, thiab muaj txiaj ntsig zoo rau kev txheeb xyuas cov thyroid nodules benign thiab malignant. FNAC xeem yuav tsum tau ua nyob rau hauv cov nram no: ① txoj kab uas hla > 1.0 cm los yog xav tias malignancy; ② txoj kab uas hla <1.0 cm;="" ③="" cov="" neeg="" mob="" qog="" nqaij="" hlav="" qog="" noj="" ntshav="" uas="" tau="" npaj="" rau="" kev="" phais="" mob="" qog="" noj="" ntshav="" lossis="" kev="" kho="" tsis="" yog="" phais.="" fnac="" biopsy="" tuaj="" yeem="" kuaj="" xyuas="" hashimoto's="" thyroiditis,="" glial="" nodules="" (nodular="" goiter),="" subacute="" thyroiditis,="" papillary="" carcinoma,="" follicular="" neoorganisms,="" medullary="" carcinoma,="" undifferentiated="" carcinoma,="" malignant="" lymphoma,="" metastatic="" carcinoma="" thiab="" lwm="" yam="" thyroid="" kab="" mob.="" txawm="" li="" cas="" los="" xij,="" fnac="" khub="" tsis="" tuaj="" yeem="" paub="" qhov="" txawv="" ntawm="" follicular="" cell="" carcinoma="" thiab="" follicular="" cell="">