TI-RADS分级和TSH:Tg比值鉴别甲状腺结节良恶性的研究  

The combination of the TSH:Tg ratio and TI-RADS for identification of benign and malignant thyroid nodules

作　　者：焦妍[1] 赵洪刚[1] 张遵城[1] 

机构地区：[1]天津医科大学第二医院核医学科,300211

出　　处：《天津医药》2016年第11期1314-1317,共4页Tianjin Medical Journal

摘　　要：目的评价B超甲状腺影像报告数据系统(TI-RADS)分级和促甲状腺素(TSH)∶甲状腺球蛋白(Tg)比值对甲状腺结节良恶性的诊断效能。方法选择2015年1月—12月我院甲乳外科甲状腺结节手术患者156例,经手术后病理诊断甲状腺乳头状癌患者50例,良性甲状腺结节患者106例。计算患者TSH∶Tg比值,采用受试者工作特征曲线(ROC)计算诊断切值,检测值<切值积0分,检测值≥切值积1分。对TI-RADS分级进行量化,3级及以下、4a、4b、4c、5级分别积0、1、2、3、4分。联用积分为TSH∶Tg比值积分和TI-RADS分级积分之和。结果 TSH∶Tg比值鉴别甲状腺结节良恶性ROC曲线下面积(AUC)为0.736,敏感度、特异度、阳性预测值、阴性预测值、诊断符合率分为64.0%、82.1%、62.7%、82.8%、76.3%。TI-RADS分级积分鉴别甲状腺结节良恶性的AUC为0.753,敏感度、特异度、阳性预测值、阴性预测值、诊断符合率分为84.0%、72.6%、59.2%、90.6%、76.3%。联用积分鉴别甲状腺结节良恶性的AUC为0.839,敏感度、特异度、阳性预测值、阴性预测值、诊断符合率分为74.0%、86.1%、71.1%、87.5%、82.1%。结论联用TI-RADS分级和TSH∶Tg比值鉴别甲状腺结节良恶性诊断效率优于单用一种方法,且简便易行,建议临床医师使用。Objective To assess the efficiency of thyroid stimulating hormone(TSH): thyroid globulin(Tg) ratio andultrasound thyroid imaging reporting data system(TI-RADS) for thyroid nodule evaluation in euthyroid patients. Methods A total of 156 patients with thyroid nodules hospitalized in the department of thyroid breast surgery from January toDecember 2015 were included in this study. There were 50 patients were diagnosed as papillary thyroid carcinoma, and 106 patients were benign thyroid nodules confirmed by pathological diagnosis after operation. The ratio of TSH:Tg was calculatedin patients. The cut- off point was calculated using the receiver operating characteristic(ROC) curve analysis. The measurement value < tangent was 0 point, and the measurement value ≥ tangent was 1 point. TI-RADS diagnostic criteria was evaluated and calculated. The nodule in TI- RADS categories 1, 2 and 3 was 0 points, The nodule in TI- RADS categories 4a, 4b, 4c, 5 was 1, 2, 3, 4 points, respectively. The combination score was the sum of the TSH:Tg ratio score and TI-RADS score. Results The area under the receiver operating characteristic curves of the TSH:Tg ratio was 0.736. The sensitivity, specificity, positive predictive value, negative predictive value, diagnose accordance rate were 64.0%, 82.1%,62.7%, 82.8%, 76.3%, respectively. The AUC of TI-RADS was 0.753, the sensitivity, specificity, positive predictive value,negative predictive value, diagnose accordance rate were 84.0%, 72.6%, 59.2%, 90.6%, 76.3%, respectively. The AUC of the combination of the TSH:Tg ratio and TI-RADS was 0.839, the sensitivity, specificity, positive predictive value, negative predictive value, diagnose accordance rate were 74.0%, 86.1%, 71.1%, 87.5%, 82.1%, respectively. Conclusion The combination diagnosis of the TSH:Tg ratio and TI-RADS for thyroid nodule evaluation in euthyroid patients is better than that of only one method, which is worth clinical popularizing and application.

关 键 词：甲状腺结节 促甲状腺素 甲状腺球蛋白 甲状腺乳头状癌 促甲状腺素 甲状腺球蛋白比值 B超甲状腺影像报告数据系统 

分 类 号：R653.2[医药卫生—外科学]