| 吕永燕,杨增娣,杨 茹,张可可,童清平,石 莹.TI-RADS分类联合血清TSH、TPOAb、TgAb检测对甲状腺良恶性结节的诊断价值[J].,2023,(11):2073-2077 |
| TI-RADS分类联合血清TSH、TPOAb、TgAb检测对甲状腺良恶性结节的诊断价值 |
| Diagnostic Value of TI-RADS Classification Combined with Serum TSH, TPOAb, TgAb Detection in Benign and Malignant Thyroid Nodules |
| 投稿时间：2023-01-06 修订日期：2023-01-28 |
| DOI：10.13241/j.cnki.pmb.2023.11.014 |
| 中文关键词: TI-RADS TSH TPOAb TgAb 甲状腺结节 诊断价值 |
| 英文关键词: TI-RADS TSH TPOAb TgAb Thyroid nodules Diagnostic value |
| 基金项目:南京军区医学科技创新课题（MS046） |
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| 中文摘要: |
| 摘要 目的：分析甲状腺影像报告和数据系统（TI-RADS）分类联合血清促甲状腺激素（TSH）、甲状腺过氧化物酶抗体（TPOAb）、甲状腺球蛋白抗体（TgAb）检测对甲状腺良恶性结节的诊断价值。方法：回顾性分析2019年1月至2021年1月中国人民解放军联勤保障部队解放军第九〇一医院收治的76例甲状腺结节患者的临床资料。术后病理结果显示32例为甲状腺恶性结节（恶性组），44例为良性结节（良性组）。对比两组超声征象以及血清TSH、TPOAb、TgAb的表达情况。甲状腺恶性结节的影响因素通过多因素Logistic回归进行分析，TI-RADS分类联合TSH、TPOAb、TgAb检测对甲状腺良恶性结节的诊断价值通过受试者工作特征（ROC）曲线进行评估。结果：恶性组结节质地为实性、边界模糊/毛刺、微钙化、内部回声为低回声、纵横比＞1、TI-RADS分类≥4类占比明显高于良性组（P＜0.05），而两组结节直径、结节数目比较无差异（P＞0.05）。恶性组TSH、TPOAb、TgAb水平均高于良性组（P＜0.05）。多因素Logistic回归分析结果显示，质地为实性、边界模糊/毛刺、微钙化、内部回声为低回声、纵横比＞1、TI-RADS分类≥4类、高TSH、高TPOAb、高TgAb水平为甲状腺恶性结节的危险因素（P＜0.05）。ROC曲线结果显示，TI-RADS分类、TSH、TPOAb、TgAb联合检测较各指标单独检测的诊断效能更高。结论：TI-RADS分类联合血清TSH、TPOAb、TgAb检测可有效鉴别甲状腺结节性质，且联合检测诊断效能更高。 |
| 英文摘要: |
| ABSTRACT Objective: To analyze the diagnostic value of thyroid imaging report and data system (TI-RADS) classification combined with serum thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TgAb) in benign and malignant thyroid nodules. Methods: The clinical data of 76 patients with thyroid nodules who were admitted to the The 901st Hospital of the Joint Logistics Support Force of PLA from January 2019 to January 2021 were retrospectively analyzed. Postoperative pathological results showed that 32 cases were malignant thyroid nodules (malignant group), and 44 cases were benign nodules (benign group). The ultrasonic signs and the expression of serum TSH, TPOAb and TgAb were compared between the two groups. The influencing factors of thyroid malignant nodules were analyzed by multifactor Logistic regression, and the diagnostic value of TI-RADS classification combined with TSH, TPOAb, and TgAb detection for benign and malignant thyroid nodules was evaluated by the receiver operating characteristic (ROC) curve. Results: The proportion of nodule texture was solid, border was blurred or burr, microcalcification, internal echo was low echo, aspect ratio greater than 1, TI-RADS classification greater than or equal to class 4 in malignant group were significantly higher than those in benign group(P<0.05), and there was no difference in the nodule diameter and number of nodules between the two groups(P＞0.05). The levels of TSH, TPOAb and TgAb in malignant group were higher than those in benign group (P<0.05). The results of multifactor Logistic regression analysis showed that texture was solid, border was blurred or burr, microcalcification, the internal echo was low echo, aspect ratio＞1, TI-RADS classification≥4, high TSH, high TPOAb and high TgAb levels were risk factors for thyroid malignant nodules(P<0.05). The ROC curve results showed that the combined detection of TI-RADS classification, TSH, TPOAb, TgAb was more effective than the independent detection of each index. Conclusion: TI-RADS classification combined with serum TSH, TPOAb, TgAb detection can effectively differentiate the nature of thyroid nodules, and the combined detection has higher diagnostic efficacy. |
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