良恶性甲状腺结节的临床特点分析  

Analysis on the clinical feature of benign and malignant thyroid nodules

作　　者：薛明淼[1] 尚梦园[2] 王志化[3] 杜睿[2] XUE Mingmiao;SHANG Mengyuan;WANG Zhihua;DU Rui(Department of Endocrinology,Affiliated Hospital of Jiangsu University,Jiangsu,Zhenjiang 212001,China;Department of Ultrasound,Affiliated Hospital of Jiangsu University,Jiangsu,Zhenjiang 212001,China;Department of Gastroenterology,Affiliated Hospital of Jiangsu University,Jiangsu,Zhenjiang 212001,China)

机构地区：[1]江苏大学附属医院内分泌科,江苏镇江212001 [2]江苏大学附属医院超声科,江苏镇江212001 [3]江苏大学附属医院消化内科,江苏镇江212001

出　　处：《中国医药科学》2020年第21期14-17,共4页China Medicine And Pharmacy

基　　金：江苏省镇江市科技项目(SH2018035)。

摘　　要：目的分析良恶性甲状腺结节患者的超声及实验室检查结果,为甲状腺结节性质判断提供依据。方法根据超声引导下细针穿刺细胞学检查(FNAC)结果将330例甲状腺结节患者分为良性结节组和恶性结节组,比较两组患者临床一般资料,探讨恶性甲状腺结节的危险因素。结果(1)恶性组平均年龄较良性组小,年龄<45岁的患者恶性结节发生率显著增高,差异均有统计学意义(P<0.05)。(2)超声检查示两组患者结节内血流、回声、边界、边缘、纵横比、结节直径比较,差异有统计学意义(P<0.05)。(3)恶性组血清TSH水平、TPOAb阳性率高于良性组(P<0.05)。(4)多因素Logistic回归分析显示,血流丰富,边缘不规则,纵横比≥1,血清TSH、FBG升高,TPOAb阳性是恶性甲状腺结节的危险因素,年龄≥45岁是恶性甲状腺结节的保护因素(P<0.05)。结论对于年龄<45岁、甲状腺结节边缘不规则、血流丰富、纵横比≥1、血清TSH、FBG升高及TPOAb阳性的患者需高度怀疑为甲状腺癌,建议进一步检查明确。Objective To analyze the ultrasonic and laboratory examination results of patients with benign and malignant thyroid nodules,so as to provide the basis for the judgment of the nature of thyroid nodules.Methods According to the examination results of ultrasound-guided fine needle aspiration cytology(FNAC),a total of 330 patients with thyroid nodules were divided into the benign nodule group and the malignant nodule group.The clinical baseline data of the two groups of patients were compared,and the risk factors of malignant thyroid nodules were discussed.Results(1)The average age of the malignant group was smaller than that of the benign group.The incidence of malignant nodules in patients of age<45 years old was significantly increased and the difference was statistically significant(P<0.05).(2)There were significant differences in blood flow,echo,boundary,edge,aspect ratio,and nodule diameter in the nodules of patients between the two groups shown by the ultrasonography,with statistically significant differences(P<0.05).(3)Serum TSH level and the positive rate of TPOAb in the malignant group were higher than those in the benign group(P<0.01).(4)It was shown by multivariate logistic regression analysis that the rich blood flow,irregular margin,aspect ratio≥1,elevated serum TSH and FBG,positive TPOAb were risk factors for malignant thyroid nodules,and age≥45 years old was the protective factor for malignant thyroid nodules(P<0.05).Conclusion Patients of age<45 years old with irregular thyroid nodule margins,rich blood flow,aspect ratio≥1,elevated serum TSH,FBG,and TPOAb positivity require high suspicion of thyroid cancer and further examination are recommended.

关 键 词：甲状腺结节 超声检查 临床特征 血清学指标 

分 类 号：R736.1[医药卫生—肿瘤]