Epidemiological and pathogenic characteristics of thyroid nodules in 58 094 people undergoing ultrasonography for health checkup

doi:10.3877/cma.j.issn.1672-6448.2020.02.014

Abstract

Abstract:

Objective

To analyze the epidemiology and disease characteristics of thyroid nodules in a healthy population to provide clinical assistance in diagnosis and treatment.

Methods

The ultrasonic testing results of 58 094 people who received health checkup at the First Affiliated Hospital of Anhui Medical University from January to December in 2018 were retrospectively collected. The pathological results and ultrasonic classification of nodules by the results of thyroid imaging report and data system (TI-RADS) were analyzed to understand the type and age distribution of thyroid nodules in Hefei area.

Results

A total of 24 047 cases (41.39%) of thyroid nodules were found in this research. The results showed that the prevalence of thyroid nodules increased gradually with age (χ²=2 017.00, P<0.01), the prevalence of nodules in men in all age groups were all significantly lower than those in women (all P<0.01). In different TI-RADS classifications, the proportions of left lobe, right lobe, and bilateral lobe in the diseased area were statistically significant (all P<0.01). The prevalence of TI-RADS was 17.30% (10 050/58 094), 22.70% (13 189/58 094), 1.23% (713/58 094), 0.15% (87/58 094), 0.01% (5/58 094), and 0.01% (3/58 094) for thyroid nodule types 2, 3, 4a, 4b, 4c, and 5, respectively, and there was a significant difference in the prevalence of thyroid nodules of different types (χ²=48 000.00, P<0.01). Three hundred and twelve patients were definitely diagnosed with carcinoma, of which 242 were benign and 70 were malignant, and the difference in the prevalence of malignancies among different TI-RADS types was statistically significant (χ²=42.79, P<0.01). Among them, papillary thyroid carcinoma accounted for 84.28% (59/70).

Conclusion

The prevalence of thyroid nodules is high. Age and gender are closely related to the prevalence of thyroid nodules.

Key words: Thyroid nodules, Ultrasonography, Epidemiology, Prevalence rate, TI-RADS classification

Lu Gan, Chaoxue Zhang, Datong Deng, Huan Du, Yongchao Chen, Chong Li, Wenqian Qiu, Shuqing Jiang, Jufen Gan. Epidemiological and pathogenic characteristics of thyroid nodules in 58 094 people undergoing ultrasonography for health checkup[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2020, 17(02): 164-168.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2020.02.014

https://chaosheng.cma-cmc.com.cn/EN/Y2020/V17/I02/164

Figures/Tables 2

References 15

1	Kwak JY, Han KH, Yoon JH, et a1. Thyroid imaging reporting and data system for US features of nodules: a step in establishing better stratification of cancer risk [J]. Radiology, 2011, 260(3): 892-899.
2	Haugen BR, Alexander EK, Bible KC, et al. 2015 American Thyroid Association Management Guidelines For Adult Patients With Thyroid Nodules And Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force On Thyroid Nodules And Differentiated Thyroid Cancer [J]. Thyroid, 2016, 26(1): 1-133.
3	Leboulleux S, Tuttle RM, Pacini F, et a1. Papillary thyroid microcarcinoma: time to shift from surgery to active surveillance? [J]. Lancet Diabetes Endocrinol, 2016, 4(11): 933-942.
4	王青平. 甲状腺结节危险因素分析 [J]. 中国地方病学杂志, 2011, 30(6): 706-708.
5	郑小燕，盛燕红，朱英. 区域甲状腺结节流行病学现状调查及评估 [J]. 中国公共卫生管理, 2015, 31(4): 553-554.
6	Sharen G, Zhang B, Zhao R, et a1. Retrospective epidemiological study of thyroid nodules by ultrasound in asymptomatic subjects [J]. Chin Med J (Engl), 2014, 127(9): 1661-1665.
7	Wang K, Yang Y, Wu Y, et a1. The association of menstrual and reproductive factors with thyroid nodules in Chinese women older than 40 years of age [J]. Endocrine, 2015, 48(2): 603-614.
8	Gharib H, Papini E, Garber JR, et a1. American association of clinical endocrinologists, American college of endocrinology, and associazione medici endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules-2016 update [J]. Endocr Pract, 2016, 22(5): 622-639.
9	Grant EG, Tessler FN, Hoang JK, et a1. Thyroid ultrasound reporting lexicon: white paper of the ACR thyroid imaging, reporting and data system of TIRADS committee [J]. J Am Coil Radiol, 2015, 12(12): 1272-1279.
10	Siraj AK, Hussain AR, AI Rasheed M, et a1. Demethylation of TMSl gene sensitizes thyroid cancer cells to TRAIL—induced ap—optosis [J]. Clin Endocrinol Metab, 2011, 96(1): E215-224.
11	赵静，赵利辉，忻晓洁, 等. 甲状腺滤泡癌与甲状腺乳头状癌的TI-RADS分类及超声特征分析 [J]. 中华普通外科杂志, 2016, 31(9): 754-757.
12	詹维伟，王文涵. 甲状腺结节的超声诊断价值 [J]. 中国普外基础与临床杂志, 2014, 21(9): 1061-1065.
13	Zhang Y, Zhou P, Tian SM, et al. Usefulness of combined use of contrast-enhanced ultrasound and TI-RADS classification for the differentiation of benign from malignant lesions of thyroid nodules [J]. Eur Radiol, 2017, 27(4): 1527-1536.
14	刘如玉，姜玉新，杨筱, 等. 甲状腺结节的影像报告与数据系统分级与2015年美国甲状腺学会推荐超声恶性风险分层的比较研究 [J]. 中华医学超声杂志（电子版）, 2017, 14(4): 263-268.
15	Nachiappan AC, Metwalli ZA, Hailey BS, et al. The thyroid: review of imaging featuresand biopsy techniques with radiologic pathologic correlation [J]. Radiographics, 2014, 34(2): 276-293.

年龄（岁）	男性			女性			合计			χ ²值	P值
年龄（岁）	例数	患病数	患病率	例数	患病数	患病率	例数	患病数	患病率	χ ²值	P值
≤29	4 392	837	19.06%	4 245	1 132	26.67%	8 637	1 969	22.80%	70.58	0.000
30~39	7 483	1 728	23.09%	6 589	2 204	33.45%	14 072	3 932	27.94%	186.17	0.000
40~49	7 148	2 460	34.42%	6 057	3 079	50.83%	13 205	5 539	41.95%	362.28	0.000
50~59	6 772	3 106	45.87%	4 964	2 832	57.05%	11 736	5 938	50.60%	142.92	0.000
60~69	3 671	2 157	58.76%	2 623	1 709	65.15%	6 294	3 866	61.42%	26.15	0.000
70~79	1 616	1 019	63.06%	1 039	736	70.84%	2 655	1 755	66.10%	17.63	0.000
≥80	1 041	697	66.95%	454	351	77.31%	1 495	1 048	70.10%	15.69	0.000

年龄（岁）	男性			女性			合计			χ ²值	P值
年龄（岁）	例数	患病数	患病率	例数	患病数	患病率	例数	患病数	患病率	χ ²值	P值
≤29	4 392	837	19.06%	4 245	1 132	26.67%	8 637	1 969	22.80%	70.58	0.000
30~39	7 483	1 728	23.09%	6 589	2 204	33.45%	14 072	3 932	27.94%	186.17	0.000
40~49	7 148	2 460	34.42%	6 057	3 079	50.83%	13 205	5 539	41.95%	362.28	0.000
50~59	6 772	3 106	45.87%	4 964	2 832	57.05%	11 736	5 938	50.60%	142.92	0.000
60~69	3 671	2 157	58.76%	2 623	1 709	65.15%	6 294	3 866	61.42%	26.15	0.000
70~79	1 616	1 019	63.06%	1 039	736	70.84%	2 655	1 755	66.10%	17.63	0.000
≥80	1 041	697	66.95%	454	351	77.31%	1 495	1 048	70.10%	15.69	0.000

分类	左侧叶	右侧叶	双侧叶
TI-RADS 2	5 421（53.94）	3 518（35.01）	1 111（11.05）
TI-RADS 3	6 506（49.33）	4 518（34.26）	2 165（16.42）
TI-RADS 4a	412（57.78）	181（25.39）	120（16.83）
TI-RADS 4b	42（48.28）	32（36.78）	13（14.94）
TI-RADS 4c	2（40.00）	2（40.00）	1（20.00）
总计	12 383（51.50）	8 251（34.32）	3 410（14.18）

分类	左侧叶	右侧叶	双侧叶
TI-RADS 2	5 421（53.94）	3 518（35.01）	1 111（11.05）
TI-RADS 3	6 506（49.33）	4 518（34.26）	2 165（16.42）
TI-RADS 4a	412（57.78）	181（25.39）	120（16.83）
TI-RADS 4b	42（48.28）	32（36.78）	13（14.94）
TI-RADS 4c	2（40.00）	2（40.00）	1（20.00）
总计	12 383（51.50）	8 251（34.32）	3 410（14.18）

[1]	Shujie Wei, Pinjing Hui, Yafang Ding, Bai Zhang, Yanhong Yan, Peng Zhou, Yabo Huang. Evaluation of cerebral hemodynamics in patients with unilateral internal carotid artery occlusion undergoing superficial temporal artery-middle cerebral artery bypass [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1046-1055.
[2]	Xuan Zhang, Yutong Ma, Yuqian Miao, Yun Zhang, Shiwen Wu, Xiaochu Dang, Yingying Chen, Zhaoming Zhong, Xuejuan Wang, Miao Hu, Yanfeng Sun, Xiuzhu Ma, Faqin Lyu, Haiyan Kou. Ultrasound assessment of diaphragm function in pediatric patients with Duchenne muscular dystrophy [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(10): 1068-1073.
[3]	Lei Ding, Wen Luo, Xiao Yang, Lina Pang, Peidi Zhang, Haijing Liu, Jiani Yuan, Jin Liu. Application of high-frame-rate contrast-enhanced ultrasound in evaluation of imaging features of C-TIRADS 4-5 thyroid nodules [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 887-894.
[4]	Qian Zhang, Jiahui Chen, Xuemeng Gao, Aoxue Zhao, Ying Huang. Value of radiomics features based on high-frame-rate contrast-enhanced ultrasound in differential diagnosis of benign and malignant thyroid nodules [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 895-903.
[5]	Lianhua Zhu, Xiang Fei, Peng Han, Bo Jiang, Nan Li, Yukun Luo. Value of high frame rate contrast-enhanced ultrasound in differential diagnosis of gallbladder polyp lesions [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 904-910.
[6]	Meifang Zhang, Ying Tan, Qiaozhen Zhu, Xin Wen, Ying Yuan, Yue Qin, Hongbo Guo, Lingxiu Hou, Wenlan Huang, Guiyan Peng, Shengli Li. Artificial intelligence-based quality control of mid-sagittal plane ultrasound images for first trimester fetal crown-rump length [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 945-950.
[7]	Ruina Zhao, Yuxin Jiang, Tao Chen, Li Zhang, Cheng Chen, Siqi Jin, Xueqi Chen, Xiao Yang, Jianchu Li. Present status and reform demands of continuing medical education for ultrasonic physicians in Beijing [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(09): 966-973.
[8]	Yuhan Zhou, Huan Xiao, Chunjiang Yang, Juan Zhou, Lirong Zhu, Juan Xu, Fangting Mou. Diagnostic value of ultrasound in children with temporary hip synovitis [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 795-800.
[9]	Huanyan Liu, Yang Hua, Lingyun Jia, Xinyu Zhao, Beibei Liu. Lumen structure and hemodynamic characteristics of occluded internal carotid artery [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 809-815.
[10]	Lianlian Zhang, Pinjing Hui, Yafang Ding. Clinical value of carotid Doppler ultrasonography in assessing vulnerability of atherosclerotic plaques [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 816-821.
[11]	Yaping Jia, Shu'e Zeng. Ultrasound and pathological characteristics of breast metaplastic carcinoma containing squamous cell carcinoma components [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(08): 844-848.
[12]	Jun Li, Jianyun Peng, Wanbing Qiu, Qianyi Dou, Fushun Pan, Jinyu Liang. Risk stratification of malignant thyroid nodules (guidelines): A comparative study of diagnostic efficacy of ACR TI-RADS versus C-TIRADS and consistency of guideline application by different physicians [J]. Chinese Archives of General Surgery(Electronic Edition), 2023, 17(06): 401-407.
[13]	Fengyun Wu, Xin Teng, Lianjuan Liu. Diagnostic value of high-frequency ultrasonography and enhanced magnetic resonance for primary hyperdifferentiated hepatocellular carcinoma of different diameters [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(06): 404-408.
[14]	Xinxin Sun, Jun Liu, Chaowu Chen, Chao Sun. Application of endoscopic ultrasonography-guided fine needle aspiration in pancreatic space-occupying lesions [J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(06): 418-421.
[15]	Da Li, Daya Zhang, Runxiang Chen, Xiaodong Zhang, Shimei Huang, Chen Chen, fan Zeng, Shiju Chen, Feihu Bai. Epidemiological characteristics and risk factors of Helicobacter pylori infection in Dongfang city of Hainan province [J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(08): 858-864.

Please choose a citation manager

Content to export