临床非典型亚急性甲状腺炎与甲状腺乳头状癌鉴别诊断模型的构建与验证  

Construction and Validation of a Differential Diagnostic Model Between Clinical Atypical Subacute Thyroiditis and Papillary Thyroid Cancer

作　　者：李春燕 刘思珍 黄达[1] 占昌苗 章春泉[1] 郭良云[1] Li Chunyan;Liu Sizhen;Huang Da;Zhan Changmiao;Zhang Chunquan;Guo Liangyun(Department of Ultrasound,The Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院超声科,南昌市330006

出　　处：《中国超声医学杂志》2024年第8期854-857,共4页Chinese Journal of Ultrasound in Medicine

基　　金：2023年江西省科技专项资金(科技计划第二批)(No.20232BAB206119)。

摘　　要：目的探讨列线图模型鉴别诊断临床非典型亚急性甲状腺炎(CAST)和甲状腺乳头状癌(PTC)的价值。方法回顾性分析经病理证实的89例CAST和123例PTC患者的临床、实验室及超声资料,筛选鉴别二者的相关预测因素并构建列线图,采用受试者工作特征(ROC)曲线下面积(AUC)评估该模型的鉴别诊断价值。结果结节内部无微钙化、向心性回声减低、周边血流信号、纵横比<1、边界模糊、周边无晕环是诊断CAST的独立预测因素(P<0.05);由上述独立预测因素构建的模型AUC为0.904,内部交叉验证AUC为0.884。结论基于结节内部无微钙化、向心性回声减低、边界模糊、周边血流信号、纵横比<1、周边无晕环6个超声特征构建的列线图对鉴别诊断CAST与PTC具有较高的价值。Objective To explore the value of the Nomogram model in distinguishing between clinical atypical subacute thyroiditis(CAST)and papillary thyroid carcinoma(PTC).Methods Clinical,laboratory and ultrasound data from 89 patients with pathologically confirmed CAST and 123 patients with PTC were retrospectively analyzed to search for independent predictors that discriminate between the two and to construct a Nomogram.The differential diagnostic value of the model was assessed using the area under the receiver operating characteristic(ROC)curve.Results The absence of microcalcifications within the nodule,centripetal hypoechoicity,peripheral blood flow signal,aspect ratio<l,blurred borders,and the absence of a halo ring were identified as independent predictors for the diagnosis of CAST(P<0.05).The area under the curve(AUC)of the model constructed from the above independent predictors was 0.904,and the AUC for internal cross-validation was 0.884.Conclusions Nomograms that integrate 6 ultrasound features(absence of microcalcifications in the nodule,centripetal hypoechoicity,blurred borders,peripheral blood flow signals,aspect ratio<l,and lack of halo ring)demonstrate high value in the differential diagnosis of CAST and PTC.

关 键 词：亚急性肉芽肿性甲状腺炎 甲状腺乳头状癌 超声检查 列线图 

分 类 号：R445.1[医药卫生—影像医学与核医学] R581.4[医药卫生—诊断学] R736.1[医药卫生—临床医学]