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目的探讨不同甲状腺背景下甲状腺癌误诊的可能原因。方法纳入研究的2 042例甲状腺癌根据甲状腺背景分为4组,正常甲状腺组织背景组(A组)、桥本氏甲状腺炎背景组(B组)、结节性甲状腺肿背景组(C组)、甲亢背景组(D组),比较不同背景下的甲状腺癌的误诊率,回顾分析误诊病例超声图像。结果 B、C、D组的误诊率比较差异没有统计学意义(P>0.05),A组的较其他3组的低,差异均有统计学意义(P<0.05)。563例误诊病例中,误诊为腺瘤225例,误诊为胶状结节202例,误诊为结节性甲状腺肿112例,误诊为钙化结节16例,误诊为桥本氏甲状腺炎6例,误诊亚急性甲状腺炎2例。结论甲状腺背景对诊断甲状腺癌有重要影响,对不同背景下甲状腺癌特殊声像认识不足是误诊主要原因。
Objective To investigate the possible causes of misdiagnosis of thyroid cancer under different thyroid gland background. Methods Twenty-two cases of thyroid cancer were enrolled in the study. Thyroid gland was divided into 4 groups according to the thyroid gland background, normal thyroid tissue background group (A group), Hashimoto’s thyroiditis background group (B group), nodular goiter group (C group) , Hyperthyroidism group (group D). The misdiagnosis rates of thyroid cancer in different backgrounds were compared. The misdiagnosis cases were retrospectively analyzed. Results There was no significant difference in misdiagnosis rates between groups B, C and D (P> 0.05). The difference between the two groups was statistically significant (P <0.05). 563 cases of misdiagnosis, misdiagnosed as adenoma in 225 cases, misdiagnosed as colloidal nodules in 202 cases, misdiagnosed as nodular goiter in 112 cases, misdiagnosed as calcified nodules in 16 cases, misdiagnosed as Hashimoto’s thyroiditis in 6 cases, Misdiagnosis of subacute thyroiditis in 2 cases. Conclusions Thyroid background has an important influence on the diagnosis of thyroid cancer. The lack of understanding of the special acoustic imaging of thyroid cancer in different backgrounds is the main reason of misdiagnosis.