血清促甲状腺激素联合超声检测对良恶性甲状腺结节的诊断价值

The Diagnostic Value of Serum Thyroid Stimulating Hormone Concomitant with Ultrasound Detection on Benign and Malignant Thyroid Nodule

目的探讨血清促甲状腺激素(TSH)联合超声检测对良恶性甲状腺结节的诊断价值。方法回顾性分析80例甲状腺结节患者的临床资料,根据术后病理资料分为良性组(n=51)和恶性组(n=29)。两组患者术前均行超声和血清TSH检测。比较两组TSH水平和超声检测各指标差异,分析TSH联合超声检测诊断恶性甲状腺结节的受试者工作特征(ROC)曲线下面积、最佳临界值、敏感性及特异性。结果恶性组患者TSH水平明显高于良性组(P<0.01),在形态规则、边界是否清晰、钙化及淋巴结转移方面与良性组比较差异有统计学意义(P<0.05或P<0.01)。TSH检测的ROC曲线下面积为0.651(与0.5相比,P<0.05),最佳临界值为0.540mIU/L,敏感性为90.1%,特异性仅为41.0%;TSH联合超声检测的ROC曲线下面积为0.812(与0.5相比,P<0.01),最佳临界值为1.523mIU/L,敏感性为85.1%,特异性为78.2%。结论血清TSH联合超声检测可以提高良恶性甲状腺结节的诊断准确性,具有重要临床价值。

Objective To explore the diagnostic value of serum thyroid stimulating hormone（TSH）concomitant with ultrasound detection on benign and malignant thyroid nodule.Methods The clinical data of 80 patients with thyroid nodule were retrospectively analyzed and divided into benign group（n=51）and malignant group（n=29）based on postoperative pathological data.Detection of ultrasound and serum TSH level was conducted to both groups before operation.Serum TSH level and each index difference of ultrasound was compared between two groups,while area under curve（AUC）of Receiver Operating Characteristic（ROC）,the optimist threshold,sensitivity and specificity of TSH concomitant with ultrasound in diagnosing malignant thyroid nodule was analyzed.Results Malignant group was evidently higher in TSH level than benign group（P〈0.01）,and had significant differences in morphological observation,boundary definition,calcification and lymph node metastasis with benign group（P〈0.05 or P〈0.01）.The AUC,the optimist threshold,sensitivity and specificity of TSH detection alone group were 0.651（compared with 0.5,P〈0.05）,0.540mIU/L,90.1% and 41.0%;respectively and in TSH concomitant with ultrasound group,they were 0.812（compared with 0.5,P〈0.01）,1.523mIU/L,85.1%and 78.2%,respectively.Conclusion Serum TSH concomitant with ultrasound detection can improve the diagnostic accuracy of benign and malignant thyroid nodule,which has important clinical value.