超声TI-RADS分级在甲状腺结节鉴别诊断中的应用价值及与患者MK、TK1、甲状腺功能指标的相关性  

Application value of ultrasound TI-RADS classification in the differential diagnosis of thyroid nodules and its correlation with patients' midkine, thymidine kinase 1, and thyroid function indicators

作　　者：李国婷 董彦金[2] 卫娜 王秀丽 Li Guoting;Dong Yanjin;Wei Na;Wang Xiuli(Department of Surgery,Jinan 2nd People's Hospital,Jinan 250021,Shandong Province,China;Department of Laboratory Medicine,Jinan 2nd People's Hospital,Jinan 250021,Shandong Province,China)

机构地区：[1]济南市第二人民医院外科,济南250021 [2]济南市第二人民医院检验科,济南250021

出　　处：《中国基层医药》2025年第3期409-413,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的分析超声甲状腺影像报告和数据系统(TI-RADS)分级在甲状腺结节鉴别诊断中的应用效果及与患者血清中期因子(MK)、胸苷激酶1(TK1)、甲状腺功能指标的相关性。方法该研究为前瞻性研究。收集2022年12月至2024年2月于济南市第二人民医院就诊的甲状腺结节患者108例(120个结节),给予超声检查,完成TI-RADS分级,检测患者血清MK、TK1水平及甲状腺功能,以患者病理结果为依据,分析TI-RADS诊断结果与病理结果的一致性,计算其诊断效能,观察TI-RADS各分级恶性结节发生情况,比较良性结节与恶性结节患者血清MK、TK1及甲状腺功能指标差异,并进行甲状腺结节患者TI-RADS分级与其血清MK、TK1及甲状腺功能指标的相关性分析。结果经病理检查检出恶性结节38个,良性结节82个;超声TI-RADS分级诊断与病理诊断结果一致性较好(Kappa=0.90,P<0.001),其诊断灵敏度、特异度、准确率分别为86.84%(33/38)、97.56%(80/82)、94.17%(113/120);超声TI-RADS分级观察中,Ⅳb及Ⅴ级甲状腺结节恶性率最高,分别为92.00%(23/25)、100.00%(10/10);恶性结节组血清MK、TK1及促甲状腺激素(TSH)水平均显著高于良性结节组(均P<0.05);相关性分析表明,TI-RADS分级与血清MK、TK1、TSH水平均呈正相关(r=0.56、0.60、0.52,均P<0.05)。结论超声TI-RADS分级可用于甲状腺结节性质鉴别,准确率高,漏诊、误诊风险低,且与患者MK、TK1、THS等指标密切相关,可为甲状腺癌的检出提供依据。ObjectiveTo analyze the application value of ultrasound Thyroid Imaging Reporting and Data System(TI-RADS)classification in the differential diagnosis of thyroid nodules and its correlation with patients'midkine,thymidine kinase 1,and thyroid function indicators.Methods This study was a prospective study.A total of 108 patients with thyroid nodules(120 nodules)who visited Jinan 2 nd People's Hospital from December 2022 to February 2024 were included.Ultrasound examinations were conducted to complete the TI-RADS classification,and serum levels of midkine(MK)and thymidine kinase 1(TK1),as well as thyroid function indicators,were measured.Based on the patients'pathological results,the consistency between the TI-RADS diagnostic results and the pathological findings was analyzed.The diagnostic efficacy of TI-RADS classification was calculated.The incidence of malignant nodules across various TI-RADS categories was assessed,and the differences in serum levels of MK,TK1,and thyroid function indicators between patients with benign and malignant nodules were compared.Additionally,a correlation analysis was performed to analyze the correlation between the TI-RADS classification of thyroid nodules and the serum levels of MK,TK1,and thyroid function indicators.Results Pathological examination results revealed 38 malignant nodules and 82 benign nodules.The consistency between ultrasound TI-RADS classification diagnoses and pathological results was good(Kappa=0.90,P<0.001),with diagnostic sensitivity,specificity,and accuracy of 86.84%(33/38),97.56%(80/82),and 94.17%(113/120),respectively.Among the ultrasound TI-RADS classifications,the malignant rates for categoryⅣb and categoryⅤthyroid nodules were the highest,at 92.00%(23/25)and 100.00%(10/10),respectively.Serum levels of MK,TK1,and thyroid-stimulating hormone(TSH)were significantly higher in patients with malignant thyroid nodules than in those with benign thyroid nodules(all P<0.05).Correlation analysis indicated that TI-RADS classification was positively correlated wi

关 键 词：甲状腺结节 超声检查 胸苷激酶 甲状腺功能试验 促甲状腺素 病理学 临床 

分 类 号：R73[医药卫生—肿瘤]