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Abstract：
Introduction The purpose of this study was to evaluate the incidence of incidental differentiated thyroid carcinoma in thyroid operations for a benign preoperative diagnosis, to identify the risk factors involved and to risk stratify the cancer patients according to the 2015 American Thyroid Association (ATA) guidelines. Materials and methods The study was a retrospective review of all thyroidectomy operations performed in a single institution (January 2004 to January 2009). We excluded patients with a preoperative diagnosis of thyroid malignancy. Results Incidental differentiated thyroid carcinoma was diagnosed in 282/1369 patients (21%). The incidental group had a significantly higher number of males (19% vs 14%, P = 0.033) and a higher number of patients with histopathological evidence of thyroiditis (35% vs 25%, P = 0.004). There was a higher number of lymph nodes present in the incidental group but numbers did not reach statistical significance (17% vs 13%, P = 0.079). There were 270 cases in the ATA low-risk group (96%) and 12 cases in the ATA intermediate-risk group (4%). Patients with an ATA intermediate risk had a statistically higher number of capsule invasion, extrathyroidal extension and angioinvasion (P < 0.001, P < 0.001 and P < 0.001, respectively). Overall, 22% of patients with an incidental differentiated thyroid carcinoma should be considered for radioactive iodine 131I treatment. 29 of the 191 patients in American Joint Committee on Cancer stage I should be considered for radioactive iodine treatment (15%). Conclusions Males and patients with thyroiditis are at a higher risk for an incidental differentiated thyroid carcinoma. One of every five of patients diagnosed with cancer will need radioactive iodine treatment, even some patients with stage I disease.
摘要：
简介本研究的目的是评估甲状腺手术中偶发分化型甲状腺癌的发生率，以进行良性术前诊断。根据2015年美国甲状腺协会(ATA)指南,确定所涉及的危险因素并对癌症患者进行风险分层.材料和方法该研究是对在单个机构中进行的所有甲状腺切除术（2004年1月至2009年1月）的回顾性回顾。我们排除了术前诊断为甲状腺恶性肿瘤的患者。结果282/1369例(21%)患者诊断为偶发分化型甲状腺癌。附带组的男性人数明显更高（19％vs14％，P=0.033）和更多的患者有组织病理学证据的甲状腺炎（35％vs25％，P=0.004)。偶发组中存在较高数量的淋巴结，但数量未达到统计学意义（17％vs13％，P=0.079)。ATA低危组270例(96%)，ATA中危组12例(4%)。具有ATA中等风险的患者具有统计学上较高的胶囊侵入次数，甲状腺外延伸和血管侵犯（分别为P<0.001，P<0.001和P<0.001）。总的来说,22％的偶发分化型甲状腺癌患者应考虑接受放射性碘131I治疗。在美国癌症联合委员会Ⅰ期的191例患者中，有29例应考虑接受放射性碘治疗（15%）。结论男性和甲状腺炎患者发生偶发分化型甲状腺癌的风险较高。每五个被诊断患有癌症的患者中就有一个需要放射性碘治疗，甚至一些患有I期疾病的患者.
