In recent years, thyroid nodules has become one of the common health problems for residents. In 2015, in the epidemiological survey of thyroid disease in ten cities in China, 15,008 of the residents were surveyed, and the total prevalence of thyroid nodules was 12.6%. That is, one in ten people suffer from thyroid nodules.
So what is a thyroid nodule? What are the dangers of it? How should I screen? What should I do if I have thyroid nodules? Hope this article can help you
What is a thyroid nodule?
thyroid nodules refer to scattered lesions caused by local abnormal growth of thyroid cells. According to the properties of nodules, thyroid nodules are divided into benign nodules and malignant nodules. For the classification of thyroid nodules, please refer to the figure below.
What are the dangers of thyroid nodules?
Benevolent thyroid nodules do not have much impact on the patient's quality of life and prognosis, but when the nodules continue to increase and compress the nerves of the surrounding tissues, some symptoms will occur, such as hoarse voice, difficulty pronunciation, dysphagia or dyspnea.
For malignant thyroid nodules, that is, thyroid cancer , it will also metastasize and infiltrate like other tumors, but more than 90% of malignant nodules can obtain a good prognosis after surgery and 131I treatment. Its 5-year survival rate is 97%, and the 10-year survival rate is 96%. For low-risk malignant thyroid nodules, the 5-year and 10-year survival rates can reach nearly 100%.
Therefore, under current medical conditions, the prognosis of most thyroid nodules is relatively good.
Which people are prone to thyroid nodules?
According to the evidence-based medical evidence from uptodate clinical consultants, in the general population, people with the following factors are at a higher risk of thyroid nodules:
●Smoking, especially in areas with mild iodine deficiency.
●Obacteria and metabolic syndrome.
●Drinking alcohol is related to enlarged thyroid, especially in women.
● Insulin-like growth factor-1 (IGF-1) level – related to male thyroid nodules and goiter in men and women.
●Uterine fibroids – A study found that women with uterine fibroids have a twice as risk of developing thyroid nodules than those with normal uterine uterine.
Which groups are at high risk of malignant thyroid nodules?
According to the domestic and foreign thyroid nodules guidelines and experts' consensus, for people suffering from thyroid nodules, the risk of malignant thyroid nodules is higher for people with the following factors:
How to screen for thyroid nodules?
Ultrasound examination: the preferred method for evaluating thyroid nodules. can determine the size, number, location, texture (solid or cystic), shape, boundary, envelope, calcification, blood supply and relationship between surrounding tissues, etc., and conduct preliminary identification of the nodules.
Tips: Everyone goes to the hospital for thyroid nodules screening, and you can choose to make an appointment for the clinic of endocrinology, general surgery or general medicine.
Is it necessary for everyone to do thyroid ultrasound examination ?
In the 2016 edition of the International Thyroid Nodule Management Guidelines: Ultrasound examination is not recommended as a screening method for the general population and people with normal thyroid palpation and low-risk thyroid disease;
Ultrasound examination is suitable for the following groups;
l high-risk thyroid malignant tumors
l palpable thyroid nodules or enlargement
l palpable thyroid nodules or enlargement
l The enlarged lymph nodes of the neck suggests malignant lesions
However, with the development of social economy, people's living habits have changed greatly, the incidence of tumors is getting higher and higher, and the number of young people suffering from tumors is also increasing. For thyroid nodules with an incidence rate of up to 12.6%, the author here recommends that people with strong health awareness should undergo an ultrasound screening of thyroid nodules.
What should I do if I find thyroid nodules?
(1) Define the properties of the nodules, evaluate the thyroid function
According to the thyroid ultrasound results and serum TSH levels, the doctor will make a preliminary judgment on the properties and functions of the thyroid nodules. If the properties of the nodules cannot be judged by ultrasound, further examinations will be conducted to clarify the properties, such as: thyroid fine needle aspiration biopsy (FNAB), thyroid angiography, etc.
(2) Treat the disease correctly and do not worry
For benign nodules without any symptoms, just follow up regularly. If the nodules become larger and have symptoms or changes in nature during the subsequent follow-up process, further treatment will be carried out;
for malignant nodules or benign nodules with compression symptoms, you should follow the doctor's advice, perform surgical procedures and 131I treatment, and you can obtain a good prognosis.
Author: Xu Yaxin
Review: Jiang Sunfang
This article is funded by Fudan University's Medical Popular Science Innovation Project.
