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초음파검사에서 성별에 따른 갑상샘 암의 빈도에 관한 연구

A Study on the Incidence of Thyroid Cancer in Gender Ultrasound

  • 곽은숙 (한서대학교 방사선학과) ;
  • 임청환 (한서대학교 방사선학과) ;
  • 양오남 (목포과학대학교 방사선과)
  • 투고 : 2015.05.01
  • 심사 : 2015.06.13
  • 발행 : 2015.06.30

초록

갑상샘 결절은 임상에서 흔히 접하게 되는 내분비 질환이며, 검사방법의 발달과 함께 건강 검진을 목적으로 시행하는 갑상샘 초음파검사에서 우연히 발견되는 갑상샘 결절 환자는 급격히 증가하고 있다. 본 연구는 대상자의 일반적 특성과 갑상샘 초음파검사, 미세침흡인세포검사를 비교 분석하여 남 녀 성별에 따른 갑상샘 결절과 갑상샘 암의 빈도 관계에 대해 알아보고자 하였다. K건강검진병원을 내원한 20세 이상 성인에서 갑상샘 질환의 기왕력이 없는 총 32,973명을 대상으로 갑상샘 초음파검사를 시행하였다. 수검자가 작성한 문진표를 통하여 일반적 특성을 조사하였고, 갑상샘 초음파검사(갑상선 결절의 유무, 크기, 개수)와 미세침흡인세포검사를 통해 악성 빈도를 알아보았다. 갑상샘 초음파검사를 시행한 32,973명의 대상자 중 결절의 유병률은 남성에서 4,611명(26.1%) 여성에서 5,341명(34.9%)으로 여성이 남성보다 유의하게 높았으며, 남 녀 모두에서 연령증가에 따라 결절의 유병률이 유의하게 증가하였다(p < 0.05). 다결절 비율은 여성이 43.5%, 남성은 35.6%로 여성이 유의하게 높았으며, 남 녀 모두에서 연령이 증가함에 따라 유의하게 증가하였다(p < 0.05). 갑상샘 초음파검사로 선별된 악성을 시사하는 692명(남성 342명, 여성 350명)의 갑상샘 결절 환자를 대상으로 미세침흡인세포검사를 시행한 결과, 성별에 따른 악성 결절의 비율은 남성에서 33.3%, 여성에서 29.4%로 통계적으로 유의하지는 않았으나 남성에서 다소 높은 것으로 나타났다. 본 연구는 성인 남 녀를 대상으로 일반적 특성, 갑상샘 초음파검사, 미세침흡인세포검사를 비교 분석하였고, 일반적 특성에 따른 갑상샘 결절의 유병률, 다결절, 결절의 크기가 성별 및 연령별에서 유의한 상관관계가 나타났다. 또한, 성인 남성의 갑상샘 결절의 유병률이 여성과 비교하여 크게 낮지 않았으며, 결절의 악성 빈도가 남성이 여성보다 다소 높은 양상을 보여 남 녀 모두에게 갑상샘 초음파검사의 역할이 중요하다고 사료된다.

Thyroid nodules are an endocrine disease often found in clinical practice, and patients with thyroid nodules found by chance have rapidly increased alongside development of thyroid ultrasound techniques for health examination purposes. This study analyzes the subjects' general characteristics, thyroid ultrasounds, and fine needle aspiration cytology in order to find out the relationship between male and female thyroid nodules and thyroid cancer frequency. An ultrasound examination of the thyroid was performed for 32,973 individuals who visited the K Hospital of Health Examination. Subjects have no history of thyroid disease and are 20 years old or over. Data of general characteristics, diabetes) was collected by a written survey completed by the subject, and the ultrasound of the thyroid(thyroid nodules existence, size, number) and FNAC was used to find out the malignancy rate. Frequency of patients with thyroid nodule was 4,611(26.1%) in men and 5,341(34.9%) in women between 32,973 individuals. Women's prevalence rate is significantly higher than men, and the prevalence rate significantly increased with age in men and women(p < 0.05). The prevalence of multiple nodules was significantly higher in women(43.5%) than in men(35.6%), and significantly increased with age in men and women(p < 0.05). The fine needle aspiration cytology was performed in 692(men 342, women 350) subjects who showed signs of malignancy through ultrasound. Prevalence of malignancy of the nodules was higher in men(33.3%) than in women(29.4%) although it is not statistically significant. It is known that thyroid nodule prevalence in women is much higher than in men. But this study shows the men's prevalence rate was not too low compared with women, and the men showed a rather higher malignancy rate in nodules than women. It is considered that the role of thyroid ultrasound is both important in men and women.

키워드

참고문헌

  1. Tomimori E, Pedrinola F, Cavaliere H, et al.: Prevalence of incidental thyroid disease in a relatively low iodine intake area. Thyroid, 5(4), 273-276, 1995 https://doi.org/10.1089/thy.1995.5.273
  2. Ezzat S, Sarti DA, Cain DR, Braunstein GD: Thyroid incidentalomas. Prevalence by palpation and ultrasonography. Arch Intern Med, 154, 1838-1840, 1994 https://doi.org/10.1001/archinte.1994.00420160075010
  3. Koike E, Noquchi S, Yamashita H, et al.: Ultrasonographic characteristics of thyroid nodules. prediction of malignancy. Arch Surg, 136(3), 334-337, 2001 https://doi.org/10.1001/archsurg.136.3.334
  4. Hyun Dae Yoon, Ho Sang Shon: The Usefulness of High Resolution Ultrasonography in the Differentiation of Thyroid Nodule. J Korean Endocrinol Soc, 20(3), 242-251, 2005 https://doi.org/10.3803/jkes.2005.20.3.242
  5. HJ Tae, KH Baek, HS Lee, et al.: Diagnostic value of Ultrasonography to distinguish between benign and malignant lesions in the management of thyroid nodules. The Korean Journal of medicine, 70(5), 535-542, 2006
  6. Horlocker TT, et al.: Prevalence of incidental nodular thyroid disease detected during high-resolution parathyroid ultrasonography. Plenum Los Alamos, NM, 1985
  7. Hegedus L: Thyroid ultrasound. Endocrinol Metab Clin North Am, 30, 339-360, 2001 https://doi.org/10.1016/S0889-8529(05)70190-0
  8. Reiners C, Wegscheider K, Schicha H, et al.: Prevalence of thyroid disorders in the working population of Germany: ultrasonography screening in 96,278 unselected employees. Thyroid, 14, 926-932, 2004 https://doi.org/10.1089/thy.2004.14.926
  9. Suk JH, Kim TY, Kim MK, et al.: Prevalence of ultrasonographically-detected thyroid nodules in adults without previous history of thyroid disease. J Korean Endocrinol Soc, 21, 389-393, 2006 https://doi.org/10.3803/jkes.2006.21.5.389
  10. JH Kim, et al.: Prevalence of thyroid nodules detected by ultrasonography in adult men attending health check-ups. J Korean Endocrinol Soc, 22, 112-117, 2007 https://doi.org/10.3803/jkes.2007.22.2.112
  11. Burch HR: Evaluation and management of the solid thyroid nodule. Endocrinol Metab Clin North Am, 24, 663-709, 1995
  12. Reiners C, Wegscheider K, Schicha H, et al.: Prevalence of thyroid disorders in the working population of Germany: ultrasonography screening in 96,278 unselected employees. Thyroid, 14, 926-932, 2004 https://doi.org/10.1089/thy.2004.14.926
  13. Suk JH, Kim TY, Kim MK, et al.: Prevalence oultrasonographically-detected thyroid nodules in adults without previous history of thyroid disease. J Korean Endocrinol Soc, 21, 389-393, 2006 https://doi.org/10.3803/jkes.2006.21.5.389
  14. Won Jun Kim, Joo Hyong Kim, Dong Won Park, et al.: Prevalence of Thyroid Nodules Detected by Ultrasonography in Adults for Health Check-Ups and Analysis of Fine Needle Aspiration Cytology. J. Korean Endocr Soc, 23, 413-419, 2008 https://doi.org/10.3803/jkes.2008.23.6.413
  15. Eun Yeong Oh, Hye Won Jang, Ji In Lee, et al.: Prevalence of Thyroid Nodules and Cancer Detected by Ultrasonography in Healthy Korean Adults: Clinical Features and the Risk for Malignancy. J Korean Thyroid Assoc, 3(2), 142-148, 2010
  16. Yim CH, Chung HK, Kim WB, et al.: Prevalence of thyroid cancer in patients with cold thyroid nodules in relation to sex, age, and multinodularity. J Korean Soc Endocrinol, 13, 366-372, 1998
  17. Belfiore A, La Rosa GL, La Porta GA, et al.: Cancer risk in patients with cold thyroid nodules: relevance of iodine intake, sex, age, and multinodularity. Am J Med, 93, 363-369, 1992 https://doi.org/10.1016/0002-9343(92)90164-7
  18. Nam-Goong IS, KIM HY, Gong G, et al.: Ultrasonography-guided fine needle aspiration of thyroid incidentaloma: correlation with pathological findings: Clin Endocrinol, 60, 21-28, 2004 https://doi.org/10.1046/j.1365-2265.2003.01912.x
  19. Kim DL, Song KH, Kim SK: High prevalence of carcinoma in ultrasonography-guided fine needle aspiration cytology of thyroid nodules. Endocr J, 55, 135-142, 2008 https://doi.org/10.1507/endocrj.K07-120
  20. Izquierdo R, Arekat MR, Knudson PE, et al.: Kartun KF, Khurana K, Kort K, Numann PJ: Comparison of palpation-guided versus ultrasound-guided fine-needle aspiration biopsies of thyroid nodules in an outpatient endocrinology practice. Endocr Pract, 12, 609-614, 2006 https://doi.org/10.4158/EP.12.6.609
  21. Miki H, Oshimo K, Inoue H, et al.: Incidence of ultrasono-graphically detected thyroid nodules in healthy adults. Tokushima J Exp Med, 40, 43-46l, 1993