Abstract
For today the question of early diagnosis of nosological variants, the method of treatment and prevention of nodular goiter in children is still not fully resolved. There is a few available literature data about study of this problem in children. Objective: to study morphofunctional structure of thyroid nodules in children.The article provides information consisting of the results of a retrospective analysis of case histories of 73 patients, operated with nodular goiter in Z.A. Bashlyaeva Children’sCityClinicalHospital(Moscow) from 2003 to May 2015. The examination included an evaluation of the functional status of the pituitary-thyroid system: there were investigated serum thyroxine, triiodothyronine and thyroid stimulating hor-mone, also was performed thyroid scintigraphy 99mТc. In the postoperative period, there was carried out a final verification of the diagnosis according to the results of the histological conclusion. The histologi-cal type of nodal disease was defined by the WHO classification of 2004. It was established that in the structure of a single-node goiter in children prevail nodular colloid goiter with equal frequency in boys and girls, with the same frequency occurs thyroid adenoma, but more often in girls than in boys. The multinodular goiter equally often detected in girls and boys both nodular goiter colloidal with varying degree of proliferation and colloid in combination with follicular thyroid adenoma. "Hot" nodes in the multinodular goiter are more common than in the single-node goiter and more fre-quently in girls than in boys. The half of children with nodular pathology have "hot" nodes and one out of every three – decompensated form of functional autonomy. Decompensated form of functional autonomy of the thyroid gland in children with "hot" nodes detects regardless of the number of nodes. Papillary thyroid cancer occurs not only in patients with a single-node, but with a multinodular goiter. The results allow to draw conclusions about the heterogeneity of the morphological structure as a single-node and multinodular goiter in children, including papillary thyroid cancer.
Highlights
The article provides information consisting of the results of a retrospective analysis of case histories of 73 patients, operated with nodular goiter in Z.A
The examination included an evaluation of the functional status of the pituitarythyroid system: there were investigated serum thyroxine, triiodothyronine and thyroid stimulating hormone, was performed thyroid scintigraphy 99mТc
There was carried out a final verification of the diagnosis according to the results of the histological conclusion
Summary
Проведен ретроспективный анализ историй болезни 73 пациентов (54 девочки, средний возраст (14,93 ± 1,75) года, и 19 мальчиков, средний возраст (14,06 ± 3,16) года), оперированных в ГБУЗ «ДГКБ им. Анализ включал изучение структуры узлового зоба с оценкой функционального состояния ЩЖ. На первом этапе все пациенты были обследованы по стандартной методике, включающей оценку анамнестических данных, пальпацию ЩЖ, УЗИ ЩЖ, тонкоигольную аспирационную пункционную биопсию, консультацию онколога, оценку функционального состояния гипофизарно-тиреоидной системы и золотой. Структура узлового зоба у детей стандарт диагностики автономно функционирующих узлов ЩЖ – сцинтиграфию. Для оценки функционального состояния гипофизарно-тиреоидной системы электрохемилюминесцентным методом на приборе Roche Elecsys 1010 определяли сывороточные уровни сТ4 и ТТГ. Все перечисленные методы обследования были направлены, в первую очередь, на исключение рака и функциональной автономии ЩЖ. Статистическая обработка фактического материала выполнена с применением программы BIOSTAT 4.03 (McGraw Hill, 1998) и включала традиционные методики вариационной статистики. Оценка статистической значимости различий абсолютных величин для рядов с нормальным распределением вариант выполнена по t-критерию Стъюдента. Значимость различий относительных величин оценивалась по критерию Фишера и χ2. Статистически значимыми считались различия при величине p ≤ 0,05
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