Dazhong Net·Poster reporter Xu Ling, correspondent Dong Zhigang reported from Jinan
With the improvement of health examination awareness, improvement of examination technology and changes in lifestyle and environment , the detection rate of thyroid nodules gradually increased. Some people get nervous when they see a thyroid nodule. In fact, thyroid nodules are not so scary. Let me tell you in detail what is going on with thyroid nodules and how we should deal with them.
I. What is a thyroid nodule?
The thyroid gland is located in the front of the neck and is a very important endocrine organ in the human body. It can secrete thyroid hormones, thereby regulating metabolism and promoting growth and development. Thyroid nodule is a general term for a mass within the thyroid gland. Thyroid nodules can be single or multiple, and multiple are common; some are superficial or large in diameter and easy to perceive, while some are deep or small in diameter (eg, less than 1 cm), easy to ignore. In most cases, thyroid nodules have no obvious symptoms and signs. If they compress the trachea or esophagus, symptoms such as difficulty swallowing, itchy throat, and difficulty breathing may occur.
According to statistics, the incidence of thyroid nodules in adults in my country is about 20.43%, about 95% of thyroid nodules are benign, but nearly 5% of nodules are malignant, we need us as soon as possible. Discovery processing. More than 90% of thyroid cancers are of low grade. After standard treatment, the 5-year survival rate is about 97%. Therefore, there is no need to panic when encountering thyroid nodules. As long as the diagnosis and treatment are standardized, we can completely overcome it.
Second, what are the causes of thyroid nodules?
There are many reasons for the formation of thyroid nodules, mainly related to the following factors: iodine deficiency or excessive intake, autoimmune dysfunction, family inheritance, history of neck radiation exposure, viral infection, emotional anxiety, depression , age factor, body mass index, etc.
Three, what needs to be checked for thyroid nodules?
Thyroid nodules are mostly discovered through physical examination. To determine the nature of thyroid nodules, in addition to surgical palpation and ultrasonography, it is also necessary to combine medical history, laboratory examinations, and even pathological examinations. Among them, ultrasonography plays an important role in the diagnosis and evaluation of thyroid nodules and thyroid cancer, and can be used for risk grading. Kwak et al. summarized five malignant characteristics of thyroid nodules, and established the TI-RADS classification with reference to the BI-RADS malignant risk classification system, which is divided into TI-RADS1: negative (malignancy rate 0); TI-RADS2: confirmed benign Lesions (malignancy rate 0); TI-RADS category 3: no suspicious ultrasound findings (malignancy rate < 5%); TI-RADS category 4: subdivided into 4a (malignancy rate 5-10%), 4b (malignancy rate 10-50%) ), 4c (malignancy rate 50-85%) three subcategories; TI-RADS category 5: (5 suspicious ultrasound findings) (malignancy rate 85-100%).
When TI-RADS1-3 category appears on the ultrasound diagnosis report, we treat it as a benign nodule; if TI-RADS4 category appears on the ultrasound diagnosis report and above, it is recommended to further check, if necessary, do a needle biopsy, and even determine whether it is malignant by surgical pathology.
Fourth, how should thyroid nodules be diagnosed and treated in a standardized manner?
It is very important to treat thyroid cancer correctly. Early detection, early diagnosis and early treatment should be done to achieve the best prognosis.
1. Nodules considered to be benign at the initial diagnosis (TI-RADS1-3 category) are recommended to be re-examined every 6-12 months; nodules that cannot be completely ruled out malignant are recommended to be re-examined every 3-6 months. If the nodule grows significantly during the observation process (increase in volume > 50%, or increase in two diameters > 2mm), or if new malignant features appear, you should go to a specialist in time to make a diagnosis as soon as possible.
2. For benign thyroid nodules, when compression symptoms begin (difficulty in breathing, obvious foreign body sensation when swallowing), or the diameter is >4cm, surgery should be considered. If it is suggested that there is secondary hyperthyroidism, surgery for the primary disease should also be considered.
3. Malignant thyroid nodules with clear clinical diagnosis: those with hard palpation, malignant changes indicated by color Doppler ultrasound, and malignant thyroid nodules confirmed by needle biopsy should be treated with surgery.
5. To delay the occurrence and development of thyroid nodules, prevention is the key.
Pay attention to the following points:
1. Regular physical examination: after 35 years of age, especially women, it is best to do thyroid B-ultrasound and thyroid function test every year;
2. Learn to relieve stress and stay relaxed. Rest on time, ensure adequate sleep, control your negative emotions, maintain a cheerful, optimistic and positive attitude;
3. Actively exercise to improve the body’s immunity.
4. Don’t overwork and stay up late;
5. Try not to be exposed to ionizing radiation. The thyroid is the most radiation-sensitive organ in the body, so possible radiation exposure should be minimized.
Finally, I would like to emphasize that regular health check-ups and the detection and monitoring of thyroid nodules are all critical. Jinan Central Hospital Health Management Center routinely provides regular physical examinations for individuals and units, and conducts comprehensive cancer screening programs. At the same time, relying on the National Cancer Center and the Jinan City Medical Insurance Pilot Cancer Early Diagnosis and Early Treatment Project, early screening of breast cancer, lung cancer, esophageal cancer, gastric cancer, colon cancer, rectal cancer, liver cancer and other tumors is carried out, so as to detect these tumors as soon as possible. Provides a strong guarantee!