SPECT/CT联合血清TSH、TRAb水平在甲状腺结节性质鉴别中的应用  

Application of SPECT/CT combined with serum TSH and TRAb levels in the identification of thyroid nodules

作　　者：卢坤 孙新峰[1] 范小涛 LU Kun;SUN Xin-feng;FAN Xiao-tao(Department of Nuclear Medicine,The Yellow River Sanmenxia Hospital,Sanmenxia Henan 472000,China;Department of Radiological,Chongqing Fengdu County People's Hospital,Chongqing 408200,China)

机构地区：[1]黄河三门峡医院核医学科,河南三门峡472000 [2]重庆丰都县人民医院放射科,重庆408200

出　　处：《临床和实验医学杂志》2025年第6期663-667,共5页Journal of Clinical and Experimental Medicine

基　　金：河南省科技攻关计划项目(编号:202006014);三门峡市科学技术项目(编号:2022002087)。

摘　　要：目的探讨单光子发射计算机断层扫描/计算机断层扫描(SPECT/CT)联合血清促甲状腺激素(TSH)、促甲状腺激素受体抗体(TRAb)水平在甲状腺结节性质鉴别中的应用。方法回顾性分析2020年12月至2022年12月在黄河三门峡医院接受治疗的150例甲状腺结节患者的临床资料,所有患者均行甲状腺结节切除术,依据术后病理学检测结果将病理诊断有明确肿瘤异型性者归为恶性组(n=45),未见癌性病灶者归为良性组(n=105)。比较两组基础资料[性别、年龄、体重指数、病程、吸烟史、饮酒史、糖代谢情况、结节数、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甲状腺素(T4)、三碘甲状腺原氨酸(T3)水平]、SPECT/CT融合显像、血清TSH、TRAb水平;采用多因素Logistic回归分析影响甲状腺结节患者恶性病变的危险因素;绘制受试者操作特征(ROC)曲线分析SPECT/CT、血清TSH、TRAb及联合指标评估甲状腺结节患者恶性病变的效能。结果两组性别构成比、年龄、体重指数、病程、吸烟史、饮酒史、糖代谢、结节数、HDL-C、LDL-C、T4、T3比较,差异均无统计学意义(P>0.05);恶性组SPECT/CT融合显像阳性占比及血清TSH、TRAb水平分别为66.67%、(5.18±1.72)mIU/L、(4.25±1.33)IU/L,均显著高于良性组[9.52%、(3.79±1.22)mIU/L、(2.91±0.95)IU/L],差异均有统计学意义(P<0.05)。经多因素Logistic回归分析证实,SPECT/CT融合显像、血清TSH、TRAb水平均是影响甲状腺结节患者恶性病变的危险因素(P<0.05)。经ROC曲线分析证实,SPECT/CT、血清TSH、TRAb及联合指标检测均可用于甲状腺结节患者恶性病变的评估,曲线下面积分别为0.786、0.790、0.815、0.952,均有P<0.05,且联合检测评估甲状腺结节患者恶性病变的效能明显高于单独检测。结论SPECT/CT融合显像、血清TSH、TRAb水平变化与甲状腺结节患者恶性病变密切相关,且SPECT/CT联合血清TSH、TRAb水平检测在�Objective To investigate the application of single photon emission computed tomography/computed tomography(SPECT/CT)combined with serum thyroid stimulating hormone(TSH)and thyrotropin receptor antibody(TRAb)levels in the identification of thyroid nodules.Methods The clinical data of 150 patients with thyroid nodules treated in The Yellow River Sanmenxia Hospital from December 2020 to December 2022 were retrospectively analyzed.All patients underwent thyroidectomy.According to the results of postoperative pathological examination,those with clear pathological diagnosis of tumor atypia were classified as the malignant group(n=45),while those without cancerous lesions were classified as the benign group(n=105).The basic data[gender,age,body mass index,course of disease,smoking history,drinking history,glucose metabolism,number of nodules,high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),thyroxine(T4),triiodothyronine(T3)],SPECT/CT fusion imaging,serum TSH and TRAb levels of the two groups were compared,and the risk factors of malignant lesions in patients with thyroid nodules were analyzed by multivariate Logistic regression.The efficacy of SPECT/CT,serum TSH,TRAb and combined indicators in the evaluation of malignant lesions in patients with thyroid nodules was analyzed by drawning receiver operation characteristic(ROC)curve.Results There were no statistically significant differences in gender composition ratio,age,body mass index,course of disease,smoking history,drinking history,glucose metabolism,nodule number,HDL-C,LDL-C,T4 and T3 between the two groups(P>0.05).The positive proportion of SPECT/CT fusion imaging and serum TSH and TRAb levels in the malignant group were 66.67%,(5.18±1.72)mIU/L and(4.25±1.33)IU/L,respectively,which were significantly higher than those in the benign group[9.52%,(3.79±1.22)mIU/L,(2.91±0.95)IU/L],the differences were statistically significant(P<0.05).Multiple Logistic regression analysis confirmed that SPECT/CT fusion imaging,serum TSH and TRA

关 键 词：甲状腺结节 良恶性鉴别 SPECT/CT 促甲状腺激素 促甲状腺激素受体抗体 

分 类 号：R581[医药卫生—内分泌]