超声引导下细针穿刺抽吸活检联合血清TPOAb、TgAb检测在甲状腺结节良恶性诊断中的应用  

Application of ultrasound-guided fine needle aspiration cytology combined with serum TPOAb and TgAb detection in the diagnosis of benign and malignant thyroid nodules

作　　者：李颖[1] 黄岩花[1] 吴爱芬 张敏[2] LI Ying;HUANG Yanhua;WU Aifen;ZHANG Min(Department of Ultrasound Medicine,Lishui Central Hospital,Lishui 323000,China;不详)

机构地区：[1]丽水市中心医院超声医学科,323000 [2]丽水市中心医院病理科,323000

出　　处：《浙江医学》2025年第4期397-402,共6页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划项目(2022ZH092)。

摘　　要：目的分析超声引导下细针穿刺抽吸活检(US-FNAC)联合血清甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)检测在甲状腺结节良恶性诊断中的应用价值。方法回顾性收集2023年1至12月丽水市中心医院就诊的甲状腺结节患者208例,以组织病理检查结果作为金标准,分为良性组(143例)与恶性组(65例),采用二元logistic回归分析患者甲状腺结节恶性的危险因素,绘制ROC曲线分析各指标的诊断效能。结果US-FNAC与病理结果有较强一致性(Kappa=0.707,P<0.05)。恶性组患者血清TPOAb、TgAb水平均高于良性组(均P<0.05)。US-FNAC(恶性)、TPOAb、TgAb均为甲状腺结节恶性的独立危险因素(OR=34.518、1.187、1.111,均P<0.05)。得到预测模型方程指标=3.541×US-FNAC+0.171×TPOAb+0.105×TgAb-6.768,ROC曲线分析得出预测模型的AUC为0.932,诊断灵敏度和特异度分别为0.897、0.916。结论US-FNAC与病理诊断甲状腺结节恶性的一致性较高,TPOAb、TgAb为甲状腺结节恶性的独立危险因素,三者联合诊断甲状腺结节恶性的效能较好。Objective To analyze the application value of ultrasound-guided fine needle aspiration cytology(USFNAC)combined with serum thyroid peroxidase antibody(TPOAb)and thyroglobulin antibody(TgAb)detection in the diagnosis of benign and malignant thyroid nodules.Methods A total of 208 patients with thyroid nodules admitted to the outpatient department of Lishui Central Hospital from January to December 2023 were retrospectively collected.Based on the results of histopathological examination as the gold standard,the patients were divided into benign group(143 cases)and malignant group(65 cases).Binary logistic regression analysis was used to identify risk factors of malignant thyroid nodules.The ROC curve was drawn to analyze the diagnostic efficacy of each factor.Results There was a strong consistency between US-FNAC and pathological results(Kappa=0.707,P<0.05).The levels of serum TPOAb and TgAb in the malignant group were higher than those of the benign group(both P<0.05).US-FNAC(malignant),TPOAb and TgAb were all independent risk factors for malignant thyroid nodules(OR=34.518,1.187,and 1.111,all P<0.05).The equation index of the prediction model was 3.541×US-FNAC+0.171×TPOAb+0.105×TgAb-6.768.The AUC of the ROC curve of the prediction model was 0.932,and the diagnostic sensitivity and specificity were 0.897 and 0.916,respectively.Conclusion US-FNAC has a high consistency with pathological diagnosis of malignant thyroid nodules.TPOAb and TgAb are independent risk factors for malignant thyroid nodules,and their combination can improve the diagnostic efficiency of malignant thyroid nodules.

关 键 词：甲状腺结节 诊断 穿刺活检 甲状腺过氧化物酶抗体 甲状腺球蛋白抗体 

分 类 号：R73[医药卫生—肿瘤]