ПРОБЛЕМЫ ДИАГНОСТИКИ УЗЛОВЫХ ОБРАЗОВАНИЙ ЩИТОВИДНЫЙ ЖЕЛЕЗЫ НА СОВРЕМЕННОМ ЭТАПЕ (ОБЗОР ЛИТЕРАТУРЫ)

Аннотация

the question of modern possibilities of complex diagnostics of thyroid nodules is considered. Despite the large number of studies conducted, it is not always possible to correctly establish an accurate morphological diagnosis of thyroid nodules, which indicates the need to improve existing and search for new, more informative diagnostic methods. In this regard, reports on the use of measurements of tissue pressure in the thyroid gland for the differential diagnosis of various pathologies of this organ are very promising. Key words: thyroid gland, morphological form, nodular formation, thyroid cancer. At present, there is a trend towards an increase drugs and sulfonamides can also give a creeping effect in the number of thyroid nodular formations (TNF) [10]. [4]. The frequency of detectable nodes in the thyroid gland The appearance of adenomas and thyroid cancer (thyroid gland) depends on the method of investigation. (thyroid cancer) is a consequence of a disorder in the cell At palpation of the thyroid gland, nodal formations are proliferation of thyroid cells. Not the last place in this is found in 4-6% of the population in areas with a sufficient allocated to the hereditary predisposition, the effects of content of iodine in water and food, in the zones of goiter ionizing radiation [8]. Identify the thyroid cancer based endemia their prevalence is somewhat higher. With on only the history and physical examination is difficult. ultrasound thyroid, the frequency of detection of This is due to the fact that most of the thyroid tumors are previously unidentified knots in adults is 13-40%. At highly differentiated and do not differ from benign autopsy of persons, who died from non-thyroid diseases, thyroid nodules. Such generally accepted criteria of nodes in the thyroid gland find more than half of people malignancy, such as rapid node growth and dense [3]. The prevalence of thyroid cancer among the nodular consistency, are of little help in the differential diagnosis formations, thyroid gland, according to different authors, of benign diseases and thyroid cancer. So, on the one is from 2.4 to 31.4%. According to V.V. Dvoyrina (2001), hand, the rapid growth of the node is often observed with the growth rate of thyroid cancer over the past decade hemorrhage to the adenoma, and in persons with was 131-133%, which is significantly higher than other thyroiditis Hashimoto in thyroid gland find dense knots, cancer. According to the American Cancer Society, about on the other hand the malignant node can be soft upon 17,000 new cases and about 1,300 deaths associated with palpation and last for a long time to exist in the thyroid thyroid cancer are reported annually in the United States. gland without signs of growth. Such criteria of knot In this regard, the problem of differential diagnosis of malignancy, as lack of displacement during swallowing, thyroid cancer becomes especially urgent [5]. hoarseness of voice, increase of regional lymph nodes, The problem of early diagnosis and timely are more specific, but are extremely rare. Meanwhile, adequate treatment of pathological formations of the clinical data should be taken into account when thyroid gland, which today are found in 4-10% of the evaluating the thyroid gland. First of all, those of them population, is still relevant. The incidence of nodal that indicate a high risk of malignancy of this node, euthyroid diseases ranges from 10 to 62%. Under the namely, the age of the patient over 60 years and under the term "nodular diseases", the nodal colloid goiter (NTG), age of 25, male gender, irradiation of the head and neck adenomas, " pseudo nodes " for chronic autoimmune area in history, knot size exceeding 3-4 cm [9]. thyroiditis (CAIT), various morphological variants of the The informative value of palpation survey thyroid gland, as well as their combinations. The fact that ranges from 35 to 62.5%, and in 25 to 36% of cases, the prevalence of focal lesions of the thyroid gland is palpable solitary nodes are multiple when using extremely high in many countries of the world, according additional techniques [10]. The analysis shows that in 26 to numerous studies. So in France, for 1,000 people, an - 40% of cases there is a discrepancy between the data of average of 35% of thyroid nodules, in the USA for 100 the palpation survey in relation to the number of nodes people, 21% (4-7% of the total population), in Japan for with operative findings [11]. Reliability of palpation 450 people - 19%. In Uzbekistan there are an average of research depends on the size and location of the node, the 10% of focal pathology per 2 thousand population [3]. A size and shape of the neck, the experience of the doctor. number of authors noted that the number of focal thyroid Along with the generally accepted laboratory tests lesions increases with age [11]. The main cause of nodal (general blood test, general urine analysis, biochemical colloid goiter is iodine deficiency of various or