Although in recent years, I always feel that more and more people come to see doctors for thyroid problems, but I don't think it is special. Unexpectedly, in recent months, people around me have been "hit hard" by thyroid problems everywhere, so we should pay more attention to thyroid.
The main reason for choosing such a topic is to shout: Don't regard thyroid nodules as a heavy burden!
Recently, such a coincidence happened: a relative of one friend after another was found with a "thyroid nodule". I had to explain it again and again: Don't panic, calm down, don't worry. The thyroid nodule can be understood, and the treatment is convenient and effective. However, patients and their families are always worried, and they are still in a state of "constant anxiety". Alas, I have no choice but to say a few more words when I am free, and let everyone take their time.
A thyroid "nodule" is very common
Whether in China or Europe, there were preliminary knowledge and records of thyroid lesions two thousand years ago. The ancient Greeks called the mass of cervical goiter a bronchial cyst. In traditional Chinese medicine, thyroid lesions are classified as "gall diseases", in which polyp galls, stone galls, and flesh galls are specific descriptions of the nature and texture of thyroid tumors.
The thyroid of the human body is like a butterfly, which is attached to the skin in front of the neck, in front of the trachea, one leaf on the left and one leaf on the right, and the isthmus in the middle.
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Figure 1 Position of thyroid gland in human neck
The size of human thyroid varies greatly due to region and age. When measured by ultrasound, it is generally 3~6cm long, 2~3cm wide, 2~2.5cm thick, and the isthmus is not thicker than 0.8cm. The weight of normal adult thyroid gland is about 18g for men and 15g for women. Although such a small piece of meat is an indispensable part of human survival, because the thyroid hormone secreted by the thyroid gland plays an extremely important role in the normal growth and development of the body and the daily metabolism of the human body. It can be said that without thyroid hormone, the human body cannot live for a day. Thyroid produces different kinds and quantities of hormones according to various environments and conditions of the human body, regulates the activities of all cells, and maintains a dynamic balance with the needs of the human body, that is, more is more, less is less.
Because thyroid hormone is synthesized in thyroid follicular cells, thyroid follicular cells and follicular cavities are the sites where thyroid hormone is synthesized and are the basic functional units of thyroid. In the complex dynamic process of the human body, thyroid cells are "active" and "resting" for a while. The thyroid cells in the long-term "tiredness" will always appear "disordered" and "active" one day, so there will be local cell proliferation and enlargement in the thyroid. When there are redundant cells in the thyroid and they gather into clusters, they are called "nodules".
Thyroid nodules are very common in the population. About 20-70% of the people can find nodules in the thyroid gland by ultrasonic examination, especially women. The number of nodules is far more than men.
The second is the "disaster" caused by B-ultrasound
As the thyroid gland is located under the skin of the neck, it is easy to be found and touched once it is enlarged. Although human history has been continuously recognized and deepened for thousands of years, the diagnosis of thyroid diseases in the past only depended on the touch of doctors, because it was affected by many factors, such as the location of the nodule in the thyroid gland, the size of the patient's neck, obesity, and the experience of the examiner, The probability of finding thyroid lesions is not high. Until the advent of ultrasound and color ultrasound technology in the late 1980s, the diagnosis of thyroid diseases was revolutionized. Nodules less than 1 cm that could not be touched in the past and changes in blood flow around the thyroid were clearly visible. In particular, the thyroid high-frequency ultrasound technology adopted in recent years can not only clearly display the thyroid anatomy, hemodynamics, microcirculation perfusion and other manifestations, but also find 2-3 mm small nodules.
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Figure 2 Ultrasonographic Findings of Normal Thyroid
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Figure 3 The nodules found in the thyroid gland by ultrasonography are hypoechoic, solid, regular in shape, and rich in blood flow
Three thyroid nodules are mostly benign
The presence of nodules in the thyroid gland can be a variety of causes. It mainly includes hyperplastic nodular goiter, neoplastic nodules (benign adenoma, malignant tumor and metastatic cancer), cystic (solid) nodules and various thyroid inflammatory nodules.
Under current medical conditions, thyroid nodules are often found through physical examination, mainly ultrasonic examination. There is no feeling on its own. Only when the nodule is large enough to compress the nearby tissues, corresponding manifestations can appear, such as dyspnea, dysphagia and hoarseness. When combined with thyroid dysfunction, corresponding clinical manifestations may occur. Inflammatory nodules are often accompanied by local pain, fever and thyroid dysfunction. Once thyroid nodules are found, do not panic, because more than 95% of thyroid nodules are benign.
4. More than 90% of thyroid cancer can be cured
In the examination of a large number of thyroid nodules, thyroid cancer is inevitable. When people hear the word "cancer", they are naturally frightened and panic. In fact, there are at least 10 types of thyroid cancer, including:
Follicular carcinoma
2 Papillary carcinoma
3 Squamous cell carcinoma
4 Undifferentiated (anaplastic) carcinoma
A Spindle cell carcinoma
B Giant cell carcinoma
C Small cell carcinoma
5 Medullary carcinoma
6 Mucous carcinoma
Mucoepidermoid carcinoma
8 Mixed cancer
……
Although there are so many types of thyroid cancer, the most common one is "papillary cancer", which can account for about 95%. And 95% of papillary carcinoma can be completely cured after treatment. In this way, even if it is cancer, we can further understand which one is, and then we can know how the treatment effect will be. It should be pointed out that treatment requires standardized comprehensive treatment, which is the most important guarantee for high cure rate.
In a word, the prevalence of thyroid nodules is high, but the proportion of malignancy is small and the degree of malignancy is low. Most benign thyroid nodules naturally turn well. At present, the medical community at home and abroad has reached a consensus that benign thyroid nodules should not be actively intervened and should be observed regularly. The emphasis is to improve the diagnostic level of thyroid ultrasonography. For thyroid nodules, regular inspection, observation and follow-up are the most appropriate treatment.
