Thyroid nodules, cut or not, this is a problem.

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With the popularity of the health of the masses and improve the concept of routine physical examination, thyroid nodule detection rate incre

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With the popularity of the health of the masses and improve the concept of routine physical examination, thyroid nodule detection rate increased year by year, the highest is about half of the ordinary people are surprised to find that he had become the "thyroid nodules" patients. Is the mood with go to the hospital, many people also found that different doctors have obvious differences in understanding and suggestion of thyroid nodule, that is to say, different doctors for thyroid nodules of different views, the recommended treatment is different, thyroid nodules, cut or not cut, really tangled and confused.

Thyroid nodules are benign and malignant (thyroid cancer), to give you a brief introduction of the current global thyroid cancer incidence trends. The current global incidence of malignant tumor is the fastest growing thyroid cancer, South Korea in the past 15 years the incidence rate increased by 15 times, China's growth rate was 4 times more than 10 years ago, the great American Thyroid Cancer (more than 2cm), lymph node metastasis and local invasion and distant metastasis of thyroid cancer increased 2 times. This shows that the incidence of thyroid cancer is indeed increased, and the proportion of high degree of malignancy increased.

Although it is often said that thyroid cancer is "lazy cancer", but this is "most" rather than "all", the rapid progress of thyroid cancer is also a dangerous "health killer". Although the proportion is not high, but fell to the head, only 0% and the possibility of the two, the probability is low, they may also be in the gun, you are willing to own health to bet on this game, do you,? More and more young people in thyroid cancer, invasive features show more and more, more and more benign thyroid cancer with expression of "camouflage", there is a growing trend, canceration factors for multifocal carcinoma to increase the proportion of outside environment, all shows the necessity of active treatment of thyroid nodules.

However, it is difficult to diagnose thyroid cancer accurately.

Many tumors, such as the gastro intestinal tract, liver, pancreas, etc., by imaging CT or magnetic resonance imaging, or through endoscopy + biopsy, can accurately determine whether the lesion is benign or malignant, and thus determine whether surgery. And thyroid nodules? There are no 100% ways to diagnose or exclude thyroid cancer! Recognized as the most valuable examination is B, experienced doctors according to the thyroid nodule boundary is not clear, vertical growth, calcification and other characteristics, can be inferred that the nodules are malignant, but these unique features are not malignant tumors, there are many such nodules after operation proved to be benign. Although there is now a fine needle aspiration cytology, help to judge from another angle, but the accuracy is only about 70-80%, that is to say, there are a lot of thyroid cancer, because not to puncture (so-called false negative) and delay the disease. Is the more advanced CT helpful? No, The diagnostic value of CT is not as accurate as tens of dollars. So, in the diagnosis of thyroid nodules, whether benign or malignant, the doctor's experience is the most important factor to decide the accuracy, but there is no one can accurately check 100% qualitative thyroid nodules, the doctor's treatment recommendations vary foreshadowed.

Even if diagnosed with thyroid cancer, doctors determine how it is difficult to develop and change.

As mentioned above, the majority of thyroid cancer is "lazy cancer", no treatment may not change significantly; but on the other hand, advanced thyroid cancer are childhood cancer development to it; there are a lot of thyroid cancer, nodules observation process does not have what change, but there is lymph node metastasis, the treatment is difficult not to mention the epidemic investigation; now that the "bad" increase in thyroid cancer. Therefore, the key is that doctors do not have any way to distinguish between a thyroid nodule will not cause serious health problems.

With this in mind, it is not difficult to understand why doctors differ in their diagnosis and treatment recommendations. First, qualitative difficulties, two is the development trend of uncertainty. Some doctors recommend regular follow-up is generally based on qualitative nodules benign, or small thyroid carcinoma, we can understand the relatively conservative treatment strategies and suggestions; positive operation, are relatively clear thyroid cancer based on its development, changes at the early stage surgery cured opportunity greatly; or for the some of the potential malignant nodules, early treatment effect is good and the operation is simple and safe, can be understood as a relatively positive treatment strategy. As a 20 year clinical experience of thyroid specialist, because clinical found many 20, 30 year old patients with thyroid carcinoma, multifocal carcinoma less than ten years ago, significantly increased a lot in the past that ultrasound is diagnosed benign nodules were malignant, and more than 25px of thyroid carcinoma distant lymph node transfer, my personal view is in favour of surgical treatment.

Then again, the removal of the thyroid what are the consequences? It should be said that, for experienced thyroid specialist, thyroid surgery related hoarseness, bleeding and other complications, the incidence is very low, the operation is very safe. And what is the effect of having a side of the thyroid gland and having a benign nodule? It should be said that, for most people, the retention of one side of the thyroid gland is sufficient to meet the needs of the body, even if the function is slightly inadequate, take half a piece of excellent music, can meet the functional needs, and almost no side effects of drugs.

Expert advice:

1, found thyroid nodules do not panic, even thyroid cancer, treatment methods, the results are good;

2, the diagnosis of thyroid cancer nodules, experienced clinical and ultrasound diagnostic accuracy is high;

3, clear or tendency of thyroid cancer diagnosis, suggest active surgical treatment;

4. Experienced surgeons have high safety and good therapeutic effect;

5, according to the doctor's advice, targeted treatment and follow-up.

About the author:

Zhang Wei, deputy director of Department of general hospital. Master tutor, associate professor, associate chief physician. In the conventional surgery and minimally invasive surgery of thyroid carcinoma and benign thyroid tumors (the scarless endoscopic thyroidectomy and endoscopic assisted minimally invasive thyroid surgery on the neck) skilled, complex thyroid surgery, such as repeated surgery, surgery of giant thyroid substernal thyroid surgery, has accumulated rich experience.

Expert clinic time: every Wednesday

 

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