剪切波弹性成像联合甲状腺球蛋白抗体诊断飞行员甲状腺结节Logistic回归分析  

Logistic regression analysis of shear wave elastography combined with thyroglobulin antibody in the diagnosis of thyroid nodules in pilots

作　　者：谢颖坤 韩蕊 郑晓慧 张巧莲 史伟伯 祝玉慧 Xie Yingkun;Han Rui;Zheng Xiaohui;Zhang Qiaolian;Shi Weibo;Zhu Yuhui(Department of Specific Diagnosis,Joint Logistics Support Force 960th Hospital Special Clinic,Ji′nan 250031,China;Department of Ultrasound Medicine,Affiliated Hospital of Heze Medical College,Heze 274005,China;Cadre ward of 960th Hospital of Joint Logistics Support Force,Ji′nan 250031,China)

机构地区：[1]联勤保障部队第九六〇医院特诊科,济南250031 [2]菏泽医学专科学校附属医院超声医学科,菏泽274005 [3]联勤保障部队第九六〇医院干部病房,济南250031

出　　处：《中华航空航天医学杂志》2023年第3期137-143,共7页Chinese Journal of Aerospace Medicine

摘　　要：目的应用Logistic回归模型评价常规超声、剪切波弹性成像、甲状腺球蛋白抗体对飞行员甲状腺结节的鉴别诊断价值。方法采用队列研究。收集2010年1月至2022年5月就诊于联勤保障部队第九六〇医院的甲状腺结节飞行员的临床资料, 包括甲状腺球蛋白抗体结果和超声图像, 以病理结果为金标准, 建立二分类Logistic回归模型, 并评价其预测结节良恶性能力。结果纳入飞行员72例, 均为男性;年龄22~55岁, 飞行时间75~5 600 h。共检出85枚结节。其中良性结节48枚, 包括结节性甲状腺肿34枚, 腺瘤10枚, 甲状腺囊性结节4枚;恶性结节37枚, 均为乳头状癌。共筛选出甲状腺结节形态、微钙化、血清甲状腺球蛋白抗体和弹性模量最大值4个有统计学意义的特征变量。Logistic回归模型对甲状腺结节良恶性预测的敏感度、特异度、准确度分别为83.9%、79.6%、81.5%, 受试者工作特征曲线下面积为0.908(95%CI:0.850~0.966)。结论剪切波弹性成像联合甲状腺球蛋白抗体建立的Logistic回归模型有较高的诊断价值, 有助于飞行员甲状腺结节的良恶性鉴别诊断。Objective To evaluate the value of conventional ultrasound,shear wave elastography and thyroglobulin antibody in the differential diagnosis of benign and malignant thyroid nodules in pilots by Logistic regression model.Methods The cohort study was used.The clinical data of pilots with thyroid nodules who were admitted to the 960th Hospital of the Joint Logistics Support Force from January of 2010 to May of 2022 were collected,including thyroglobulin antibody results and ultrasound images.The pathological results were used as the gold standard to establish a binary Logistic regression model and evaluate its ability to predict benign and malignant nodules.Results Seventy-two pilots were included,all were male,with 22-55 years old and 75-5600 h flying hours.A total of 85 nodules were detected.Among them,48 nodules were benign nodules,including 34 nodular goiters,10 adenomas,and 4 thyroid cystic nodules.There were 37 malignant nodules,all of which were papillary carcinomas.A total of 4 statistically significant characteristic variables were screened out,including thyroid nodule morphology,microcalcification,serum thyroglobulin antibody,and maximum elastic modulus.The sensitivity,specificity and accuracy of Logistic regression model in predicting benign and malignant thyroid nodules was 83.9%,79.6%and 81.5%,respectively.The area under the receiver operating characteristic curve was 0.908(95%CI:0.850-0.966).Conclusions The Logistic regression model established by shear wave elastography combined with thyroglobulin antibody has high diagnostic value.It is helpful to the differential diagnosis of benign and malignant thyroid nodules in pilots.

关 键 词：甲状腺结节 甲状腺球蛋白 抗体 超声检查 Logistic模型 飞行员 

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]