相关实验室检查和超声特征在分化型甲状腺癌与结节性甲状腺肿鉴别诊断中的意义

发布时间：2018-05-07 07:57

  本文选题：超声特征 + 分化型甲状腺癌　； 参考：《中国超声医学杂志》2017年10期

【摘要】：目的探讨分化型甲状腺癌(DTC)与结节性甲状腺肿(NG)在相关实验室检查指标(TSH、TG、TGAb、TPOAb)及超声影像特征方面的差异。方法回顾性分析在我院行甲状腺部分或全部切除术,且术后病理证实为DTC或NG的354例患者术前超声检查图像特征及TSH、TG、TGAb、TPOAb水平,并进行多因素分析,绘制ROC曲线,评价其在DTC和NG鉴别诊断中的意义。结果多因素分析结果显示DTC组TSH、TG、TGAb、TPOAb水平高于NG组;DTC组内纵横比≥1、有微小钙化、边缘不规整、形态不规则、极低回声、内部结构为实性、结节为单发的比例高于NG组,均有统计学差异。两组在结节大小、实质回声不均匀性、结节内血流方面无统计学差异。绘制结节数目、TSH、纵横比、形态、边缘、综合指标的ROC曲线,形态、边缘、综合指标ROC曲线下面积分别为0.80、0.85、0.96,有很好诊断价值。结论 TSH、TG、TGAb、TPOAb水平升高,纵横比≥1、有微小钙化、边缘不规整、形态不规则、极低回声、内部结构为实性,结节为单发是DTC的危险因素。结节数目、TSH、纵横比、形态、边缘联合形成综合指标对于鉴别DTC和NG具有很高的诊断价值。
[Abstract]:Objective to investigate the difference between differentiated thyroid carcinoma (DTC) and nodular goiter (NGN) in laboratory examination of TSHT TGAbTGAbTPOAband the characteristics of ultrasound. Methods the ultrasonographic features and the level of TGAb-TPOAb were analyzed retrospectively in 354 patients who underwent partial or total thyroidectomy in our hospital and proved to be DTC or NG by pathology. The ROC curves were plotted by multivariate analysis. To evaluate its significance in differential diagnosis of DTC and NG. Results the results of multivariate analysis showed that the level of TSH TGG Ab in DTC group was higher than that in NG group (P > 1), with slight calcification, irregular margin, irregular shape, very low echo, solid internal structure, and higher incidence of single nodules than those in NG group. There was statistical difference between the two groups. There were no significant differences in nodule size, parenchymal echo heterogeneity and blood flow within the nodules between the two groups. The ROC curve, shape, edge and ROC curve of the number of nodules, aspect ratio, shape, edge and synthetic index were drawn, and the area under the ROC curve was 0.80 and 0.850.96, respectively, which had very good diagnostic value. Conclusion the level of TGAb-TPOAb is increased, the aspect ratio 鈮，

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