甲状腺结节和分化型甲状腺癌诊疗指引-欢迎访问中华老年多器官疾病.DOC

甲状腺结节甲状腺癌中国甲状腺结节和分化型甲状腺癌诊治指南解读甲状腺结节是一种临床常见病B超检查发现的甲状腺结节患病率为20%～76%，其中甲状腺癌的患病率约为5%～15%。鉴别甲状腺结节的良恶性和评估对周围组织的损害是诊断的重点。收集完整病史131I治疗和促甲状腺激素（TSH）抑制治疗是甲状腺癌的治疗方法。甲状腺结节和甲状腺癌应视具体情况安排不同时间间隔的随访。与中青年人群相比老年人群甲状腺结节的患病率增高，甲状腺癌的发生率低，治疗原则相同。 【关键词】甲状腺结节；甲状腺癌；诊断；治疗；随访 New Diagnosis and management for Thyroid Nodule and Carcinoma ——the Chinese management guidelines for patients with thyroid nodules and differentiated thyroid cancer Gong Yanping Tian Hui Department of Geriatric Endocrinology, Chinese PLA General Hospital, Beijing 100853 Email：gypmrp@ Thyroid nodule is a prevalent clinical disease, the prevalence of ultrasonic inspection for thyroid nodule is 20 - 76%. At the same time the morbidity of thyroid presented higher in China, the incident of thyroid cancer detected from thyroid nodule reached 5-15% in recent years. Therefore identifying benign and malignant, and the damage of surrounding tissue of thyroid nodules is particularly important. Risk factors of thyroid cancer developed from thyroid nodules could be evaluated by collecting complete medical history, and this might do great help to arrange reasonable diagnosis and treatment methods. High resolution ultrasound evaluation is the preferred method of thyroid nodule. Biopsy has the highest accuracy (83%) and specificity (92%) in assessment benign and malignancy of thyroid nodule. Other laboratory and imaging examination can play a supplementary role. Surgery, postoperative 131I therapy and TSH suppression therapy is the treatment of thyroid cancer method. The methods of surgical treatment and lymphatic cleaning is the key consideration. The follow-up schedule of thyroid nodules and thyroid carcinoma should be arranged according to each specific situation. Though the prevalence of thyroid nodule is higher in elder than young subjects, but the incidence of thyroid carcinoma in elder is relatively lower, and the therapy methods of elder is the same as that of young. 【关键词】thyroid nodule；carcinoma；diagnosis；therapy; follow-