Thyroid nodule is one of the common clinical thyroid diseases. Since its clinical manifestations are not many, many people discover it during physical examination. However, because they are relatively unfamiliar with this disease, many people find thyroid nodules after Just think about whether surgical treatment is needed and whether it will develop into malignant lesions. In fact, most thyroid nodules are benign. In the absence of obvious thyroid dysfunction , you only need to take daily precautions.
Ms. Chen, who is in her 40s, is the leader of a company. Her work pressure is relatively high, and it is common for her to stay up late and work overtime. In a recent employee physical examination organized by the company, Ms. Chen's thyroid color ultrasound showed that she had cystic nodules in the left lobe of the thyroid gland, TI-RADS: Level 2, This was not seen in the previous physical examination, and Ms. Chen was afraid that she had Thyroid cancer , so I quickly consulted the doctor. The doctor checked again and found that Ms. Chen’s thyroid function was normal, so he suggested that Ms. Chen should be reviewed regularly. Ms. Chen was a little scared and further asked the doctor if she had cancer. The doctor explained that clinically 99% of thyroid nodules are benign, especially thyroid nodules with a TI-RADS grade of 3 or below. They are not considered to be thyroid nodules. Malignant tumor, but if scientific prevention and treatment is not carried out, there is still the possibility of developing into a malignant disease, so I gave Ms. Chen several suggestions and asked her to review thyroid color ultrasound and thyroid function every six months.
Thyroid nodules are one of the common thyroid diseases in clinical practice. They are more common in middle-aged and older women. According to epidemiology, found that the incidence of thyroid nodules in women over 40 years old is as high as 13%, but this data may be biased. Low, because most thyroid nodules have no obvious clinical symptoms, and general physical examination cannot detect them. Professional thyroid ultrasound examination is required to improve the diagnostic efficiency, so many people are discovered during physical examination. Although most thyroid nodules are benign lesions, if scientific prevention and treatment is not carried out, about 5% may develop into thyroid cancer. Therefore, we cannot be afraid of this disease, nor should we underestimate it. We must use science and objectivity attitude towards prevention and control.
1. The pathogenesis of thyroid nodules
Thyroid nodules are abnormal proliferation of thyroid cells, resulting in hard nodules or masses formed inside the thyroid . It is one of the common diseases of the thyroid gland. Modern research shows that there are many causes of thyroid nodules in life, such as age, gender, iodine intake, autoimmunity, etc., which may induce thyroid nodules, and early thyroid nodules do not have obvious clinical symptoms. Therefore, it is very easy to miss diagnosis clinically. Many people discover that they have thyroid nodules for the first time during physical examination.
The pathogenesis of thyroid nodules is still unclear, but the pathological proliferation of thyroid tissue cells induced by various inducements is the main feature of this disease . Clinically, thyroid nodules are divided into nodules based on their morphology and characteristics. There are 4 categories: goiter, nodular toxic goiter, inflammatory nodules and malignant thyroid nodules.
1, Nodular goiter
Nodular goiter is the most common type of thyroid nodule in clinical practice, accounting for about 60%-79%. The main pathogenesis of nodular goiter is that the body secretes too much thyroid-stimulating hormone , which leads to the continuous proliferation of the thyroid gland under the stimulation of thyroid-stimulating hormone, and then the formation of nodular-like lesions on the thyroid gland. Nodular goiter is mostly a benign lesion. Under thyroid ultrasound, it usually appears as one or more light to medium hard nodules. The structure can be cystic or solid, with clear edges and clear structure.The clinical manifestation of nodular goiter is that the size of the thyroid gland increases, causing discomfort in the throat of the patient. However, it has no significant impact on thyroid function, but a small number of patients may develop further.
2, nodular toxic goiter
Nodular toxic goiter is mostly developed from nodular goiter, accounts for about 15% of thyroid nodule patients.. The most prominent feature of nodular toxic goiter is that it also affects thyroid function on the basis of thyroid enlargement. In particular, it is easy to cause hyperthyroidism. Patients can show symptoms of hyperthyroidism such as hot flashes, irritability, and mild exophthalmos. . Thyroid ultrasound shows medium round or oval nodules with clear borders, clear structure, and no abnormal blood vessel signals. Most of them are benign, but a small number of them may develop further.
3, inflammatory nodules
Inflammatory thyroid nodules are a type of subacute thyroiditis caused by viral infection, accounting for about 10% in clinical practice. The clinical manifestations of this kind of inflammatory nodule are more obvious. In addition to one or more nodules on palpation, there will also be obvious fever, local pain in the thyroid gland, etc., and thyroid balls can be found in blood tests. The protein antibody and thyroid microsomal antibody are strongly positive. This inflammatory nodule itself is benign, but there is a certain probability of developing into a malignant nodule.
4, malignant thyroid nodules
The types of malignant thyroid nodules include anaplastic thyroid carcinoma , medullary thyroid carcinoma and other malignant diseases, accounting for about 5% of thyroid nodules. Malignant thyroid nodules often present clinically as significant enlargement of the thyroid gland, or the appearance of masses, and at the same time there is a significant sense of oppression on the surrounding tissues. It may be accompanied by hoarseness, difficulty eating, etc. Under ultrasound, the shape of malignant thyroid nodules is irregular, the edges are blurred, and enlarged lymph nodes can be seen around it. Different types of malignant thyroid nodules have different prognosis. The 3-year survival rate of anaplastic thyroid cancer is less than 5%, while the 10-year survival rate of papillary adenocarcinoma after treatment is as high as 90%. Therefore, identifying the type and active treatment are key.
2. Factors that induce thyroid nodules
Clinical studies have shown that there are many causes of thyroid nodules, which are related to iodine intake, genetic factors, gender, radiation and other factors.
1, Gender
Clinical studies show that women are much more likely to suffer from thyroid nodules than men , among which the incidence rate in elderly women is as high as 52%. The cause of this phenomenon is not yet clear, but it may be related to the body of women after menopause. Associated with drastic changes in hormone levels.
2. Iodine intake
Clinical studies have shown that daily iodine intake has a significant impact on the prevalence of thyroid nodules. Among them, patients with thyroid nodules, thyroid cancer and other diseases in areas with high iodine (such as coastal cities, etc.) The disease rate is higher than that in iodine-appropriate areas, but the prevalence of nodular goiter in low-iodine areas is higher than in iodine-appropriate areas. In other words, whether the iodine intake is too high or too low, it will induce thyroid nodules. , when the intake of iodine is too high, it is easy to induce malignant thyroid nodules, so the intake of iodine must be controlled in life.
3, history of exposure to radioactive materials
Epidemiological studies have found that medical staff working in the radiology department are much more likely to suffer from thyroid nodules, thyroid tumors and other diseases than the general population, This shows that radioactive radiation is responsible for the formation of thyroid nodules Risk factors , so exposure to radioactive substances should be minimized in life. Among them, the most easily overlooked is radioactive diagnosis and treatment, such as X-rays, CT, etc.
4. Genetic factors
People with a family history have a higher prevalence of thyroid nodules , and genetic studies have found that BRAF gene mutations are significantly related to the incidence of thyroid disease, which indicates that thyroid nodules are related to genetic factors to a certain extent. relation.
5, bad habits
Epidemiological studies have shown that bad habits such as smoking, drinking, and staying up late are related to the incidence of thyroid nodules. Although the specific mechanism of action is not obvious, it may be related to the impact of these bad habits on human hormone metabolism. .
3. How to distinguish benign and malignant thyroid nodules after discovering them?
Many patients' fear of thyroid nodules comes from the inability to distinguish between benign and malignant. In fact, the vast majority of thyroid nodules are benign. Everyone must follow the doctor's diagnosis. In addition to professional color ultrasound and blood tests, We can judge from the following points in our lives.
1. Clinical symptoms
The clinical symptoms of benign thyroid nodules are often not obvious . Most of them only show pharyngeal discomfort, or mild hyperthyroidism due to affecting thyroid function. They are often small in size and can go up and down with swallowing. Move; malignant thyroid nodules grow rapidly and may be accompanied by obvious difficulty in swallowing, hoarseness, choking on drinking water and coughing. This is because malignant thyroid nodules can easily cause damage to the surrounding esophagus, trachea, throat and other tissues and organs. Extrusion and erosion.
2. Palpation examination
Benign thyroid nodules are often soft in texture and have clear boundaries, and can be moved up and down with swallowing; malignant thyroid nodules are often hard in texture, have unclear boundaries, and have poor mobility.
3. Is it accompanied by cervical lymph node enlargement?
Cervical lymph nodes are the lymph node group closest to the thyroid gland, and are also the most susceptible lymph nodes . Benign thyroid nodules have little impact on cervical lymph nodes and will hardly cause them to swell, while malignant thyroid nodules are very likely to cause cervical lymph node enlargement in the early stage and even metastasize to other lymph nodes.
4. The following points should be done to prevent and treat thyroid nodules in life
Most benign thyroid nodules do not require treatment and only require regular review, while malignant thyroid nodules require specialist intervention and early treatment, regardless of whether they are benign or malignant. , it is very important to take daily precautions in life.
1. Pay attention to the intake of iodine
Whether excessive or insufficient iodine intake will lead to the induction of thyroid nodules, it is very necessary to understand your own situation and take in an appropriate amount of iodine. You can determine whether you are deficient in iodine or have too much iodine by testing serum iodine and thyroid function.. If you are iodine deficient, it is recommended to increase your iodine intake. You can eat more iodine-containing foods, such as kelp, seaweed, seafood and other seafood. However, if you have excessive iodine in your body, you need to limit your iodine intake. Enter, not only cannot eat the above foods, but also need to reduce the intake of iodized salt, and try to eat low-iodine or non-iodized salt.
2. Develop good living habits
Quitting smoking and drinking are effective means to prevent and treat thyroid nodules. At the same time, reducing bad habits such as staying up late and drinking coffee play an important role in protecting the normal production and release of thyroid hormones in the human body, so these bad habits should be avoided as much as possible. Habit.
3. Pay attention to a healthy diet.
In daily life, you must limit the intake of high-fat and high-calorie foods. Try to focus on light foods. Eat more fresh vegetables to ensure adequate amounts of vitamins and minerals to ensure normal health. Nutritional supply to meet human health needs.
4. Regular review of relevant indicators
For patients with clear thyroid nodules, it is recommended to review relevant indicators regularly. Specific examination items include thyroid color ultrasound, thyroid function, thyroid antibodies, lymph node color ultrasound, neck color ultrasound, etc., which can be performed when necessary puncture examination of thyroid nodules or iodine radiation examination , so as to understand the development of the disease at all times and provide timely symptomatic treatment.
5. Summary
In summary, if we find thyroid nodules during the physical examination, we don’t need to worry too much. We can consult a clinician immediately. If necessary, we can conduct a specialist examination to clarify the condition and obtain timely treatment; secondly, pay attention Daily precautions in life are of great significance to the prevention and treatment of thyroid nodules. Adjust your own living habits and review relevant indicators regularly.
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