The thyroid gland is the largest endocrine gland in the body and also one of the most susceptible to disease. From a surgical point of view, thyroid diseases are categorized into thyroid adenoma, nodular goiter, hyperthyroidism, chronic lymphoid thyroiditis and thyroid cancer. The high incidence of thyroid disease is concentrated in the age group of 30-50 years old, with a predominance of females, roughly seven times that of males. Although the incidence rate of thyroid disease is high, its prognosis is very good, as long as early detection, standardized treatment, the cure rate of thyroid cancer is very high, the ten-year survival rate is about 95.2%. 1.Which thyroid nodules should be alerted to cancer The incidence rate of thyroid nodules is 7%, which is very high (for example, the incidence rate of stomach cancer is 50/100,000). The nodule may be benign or cancerous, and it is thought that one in four solid, solitary thyroid nodules is thyroid cancer. A thyroid nodule is a nodular growth on the thyroid gland, which may be nodular goiter in nature, or granuloma, thyroiditis, thyroid tumor, or thyroid cancer, all of which are collectively referred to as a thyroid nodule until they are characterized. The size of a thyroid nodule is not the only indicator of the need for surgery. Some nodules may be as small as 0.8 centimeters in diameter, but if they have a tendency to become malignant, they need to be removed as soon as possible. If the nodule appears to be benign on ultrasound, then we would only consider removing it when the nodule is 3 to 4 centimeters. If the ultrasound indicates a thyroid adenoma, it is also best to remove it surgically because 10% of thyroid adenomas become cancerous as they grow. How do I know if a nodule is malignant? Thyroid nodules need to be alerted to the following situations: 1, a single nodule is more dangerous than multiple; 2, a single nodule is hard, fixed, and painless; 3, it grows fast; 4, ultrasound suggests that there are tiny calcification points in the nodule; 5, ultrasound suggests that it is a hypoechoic nodule, and the hypoechoic nodule is more likely to be malignant than the middle or hyperechoic nodule; 6, the solid nodule is more dangerous than the cystic or cystic solid nodule; 7, there is enlargement in the neighboring cervical lymph nodes; 8, it causes pressure symptoms or sounds; 9, it may cause pressure symptoms or cause a sound; 10, it is better to have a surgery because 10% of the tumor will be cancerous during the growth process. The presence of a thyroid nodule can cause symptoms of pressure or hoarseness. 2, not all thyroid nodules need surgery Now many hospitals take a one-size-fits-all approach to thyroid nodules, as long as the diagnosis is a nodule, regardless of single-issue multiple-issue, benign malignant, are taken to surgery. Liu Yuewu pointed out that such an approach is not desirable. Like some nodular goiter, itself belongs to multiple nodules, and almost not cancerous, if it is removed at about 1, 2 cm, the harm is greater than the good. Surgery is usually needed for multiple goiters that are so large in diameter that they cause an unsightly neck, or press on the windpipe, or cause hyperthyroidism. Because nodular goiter tends to grow back after surgery, if a woman develops nodules at age 40, she may not need surgery until she is in her 50s because of the slow growth of the nodules, so that even if the nodules grow back after surgery, most of them will not need surgery again in her lifetime. However, if the operation is performed at the age of 40, you may need another operation at the age of 55 because of the reoccurring and growing nodules, and if the operation is not done properly, you may need a third operation after the age of 55. Moreover, due to the adhesion after surgery, the chances of laryngeal recurrent nerve damage caused by re-operation will increase significantly, resulting in hoarseness; for example, the probability of laryngeal recurrent nerve damage in the first surgery is about 0.1%, and the second is 3%. 3.Thyroid cancer is a malignant tumor with high cure rate In recent years, the incidence rate of thyroid cancer has shown a significant upward trend, and the incidence rate is almost 300% of the past. The first reason is that people pay more attention to their health and pay more attention to the physical examination, especially the updating of the examination technology such as neck ultrasound and CT, which makes the previously neglected and asymptomatic cases to be discovered. Secondly, other factors such as the environment, diet and personal emotions may also be responsible for triggering the increased incidence of thyroid cancer. Thyroid cancer cells grow slowly and are not highly malignant. In addition, the most common type of thyroid cancer is papillary cancer, which does not easily metastasize from the bloodstream, but mainly from lymphatic metastasis, thus most of them metastasize only in the neck, which is easy to treat. Thyroid cancer is not sensitive to chemotherapy. Generally speaking, patients in middle and late stages need radiotherapy after surgery, while early stage, even and some middle stage patients can be treated without radiotherapy. The prognosis of early thyroid cancer is good, after surgery, the survival rate of ten years is about 95%. However, he also reminded patients that they should not think that thyroid cancer is “safe” because of its low malignancy; if it is not detected and diagnosed at an early stage, and if it is not treated in a timely manner, the prognosis of late-stage thyroid cancer after surgery will be affected. In addition, even if some cancerous tumors are small, if they grow close to the recurrent laryngeal nerve, they will invade the nerve at an early stage and lead to hoarseness, which is not uncommon in this kind of cases. 4, Chopin’s disease on the basis of the high rate of cancerous nodules Chronic lymphoid thyroiditis, also known as Chopin’s disease, is one of the most common types of thyroiditis. It is a type of autoimmune disease in which the body produces lymphocytes that attack the thyroid gland. Chopin’s disease has a slow onset, patients generally have no special feelings, often found inadvertently enlarged thyroid gland, usually diffuse symmetrical enlargement, can also be more pronounced on one side of the enlargement, most cases have no symptoms, a small number of cases can be seen in a slight pain or neck tightness and other symptoms of pressure, the texture of the tougher such as touching the sense of rubber. Thyroid function is mostly in the normal range, and a few cases may have hyperthyroidism, such as nervousness, palpitation, and fear of heat, etc. With the progress of the disease, when the destruction of the thyroid gland reaches a certain degree, more than half of the patients may have hypothyroidism symptoms in the late stage, such as chills, fatigue, and weight gain. The nodules that grow on top of Hashimoto’s disease are prone to become cancerous, and some studies have suggested that the percentage of cancerous changes is as high as 23%. Therefore, for people with thyroiditis combined with thyroid nodules, the indications for surgery need to be appropriately relaxed. 5, thyroid regular regular checkup is the way out With the increase of social competition and work pressure, thyroid disease has been on the rise in recent years. Because this disease has a certain degree of invisibility, it is not easy to find in the early stage, so early detection and early prevention seems to be more important. “Especially for women under stress, it is best to add a thyroid color ultrasound to the routine physical examination. Color ultrasound is the best means of diagnosing thyroid disease, and in addition to being very accurate, it is also economical and non-invasive.” It’s also a good idea for patients who have been diagnosed with benign thyroid nodules to see a specialist every six months for a formal checkup and proper treatment.