彩超联合血清TSH、p53、VEGF检测对甲状腺结节良恶性的诊断价值  

Diagnostic value of color Doppler ultrasound combined with serum TSH,p53 and VEGF in thyroid nodule

作　　者：马磊 周丽霞[1] 卢冬敏[1] MA Lei;ZHOU Li-xia;LU Dong-min(Department of Ultrasound,Qinhuangdao Second Hospital,Qinhuangdao 063000,Hebei,China)

机构地区：[1]秦皇岛市第二医院超声科,河北秦皇岛063000

出　　处：《川北医学院学报》2020年第6期1063-1066,共4页Journal of North Sichuan Medical College

摘　　要：目的:探讨彩色多普勒超声(彩超)联合血清促甲状腺激素(TSH)、p53、血管内皮生长因子(VEGF)检测对甲状腺结节良恶性的诊断价值。方法:分析74例接受甲状腺结节手术患者的临床资料,以病理诊断结果为金标准,其中良性结节49例,记为良性组,恶性结节25例,记为恶性组。比较两组患者超声图像特征、超声良恶性鉴别效果和血清TSH、p53、VEGF水平差异,采用受试者工作特征(ROC)分析血清TSH、p53、VEGF对甲状腺恶性结节的诊断效果。结果:良性组和恶性组的结节形态、边界、声晕、回声、钙化、血流分级、淋巴结肿大和包膜侵犯比较,差异有统计学意义(P<0.05),结节数量比较,差异无统计学意义(P>0.05);彩超良性结节检出率高于恶性结节(87.01%vs.66.67%,P<0.05);恶性组血清TSH、p53、VEGF水平均高于良性组(P<0.05),诊断甲状腺恶性结节的曲线下面积(AUC)依次为0.725、0.764、0.759,3项联合检测时AUC为0.883,敏感度85.71%,特异度89.61%。结论:彩超联合血清TSH、p53、VEGF检测对临床鉴别诊断甲状腺结节良恶性价值显著。Objective:To investigate the diagnostic value of color Doppler ultrasound(CDUS)combined with serum TSH,p53 and VEGF in the diagnosis of benign and malignant thyroid nodules.Methods:74 patients who underwent thyroid nodule surgery selected as the study objects.The results of operation and pathology were gold standard,including 49 cases of benign nodule,which were recorded as benign group,25 cases of malignant nodule,which were recorded as malignant group.The difference between the two groups in ultrasonic image characteristics,ultrasonic benign and malignant differentiation effect and serum TSH,p53 and VEGF levels were compared,and the diagnostic effect of serum TSH,p53 and VEGF on thyroid malignant nodules were analyzed by ROC.Results:There were significant differences between benign group and malignant group in nodule shape,boundary,halo,echo,calcification,blood flow classification,lymphadenopathy and capsule invasion(P<0.05),there was no significant difference in the number of nodules(P>0.05).According to the pathological gold standard,the detection rate of CDFI benign nodules was higher than that of malignant nodules(87.01%vs.66.67%,P<0.05).The levels of TSH,p53 and VEGF in malignant group were significantly higher than those in benign group(P<0.05),the subcurve area(AUC)was 0.725,0.764 and 0.759,respectively,the AUC,sensitivity and specificity of the 3 indexes were 0.883,85.71%and 89.61%,respectively.Conclusion:Color Doppler ultrasound combined with serum TSH,p53,VEGF detection of clinical differential diagnosis of benign and malignant thyroid nodules has significant value.

关 键 词：甲状腺结节 良恶性 彩超 促甲状腺激素 P53 血管内皮生长因子 诊断价值 

分 类 号：R445.1[医药卫生—影像医学与核医学] R581[医药卫生—诊断学]