不同类型甲状腺钙化结节超声病理相关性研究

A correlation analysis of calcification patterns and biopsy in thyroid nodules

目的探讨钙化灶在甲状腺结节良恶性诊断中的意义。方法回顾性分析1 344例行粗针穿刺的甲状腺结节,将其按有无钙化及不同钙化类型进行归类,分为无钙化、簇状微钙化、小钙化、粗大钙化及环状钙化组。统计其与结节良恶性的关系。结果 1 344例结节中,良性972例,恶性372例;有钙化744例,无钙化600例。恶性结节钙化发生率(66.13%)、簇状微钙化发生率(72.22%)及小钙化发生率(41.94%)均高于良性结节(P<0.01)。钙化诊断甲状腺结节良恶性的特异度和灵敏度分别为66.13%和48.77%,阳性预测值及阴性预测值分别为33.06%及79.00%。簇状微钙化特异度更高,其特异度为97.94%,灵敏度为13.98%,阳性预测值及阴性预测值分别为72.22%及74.84%。结论簇状分布的微钙化诊断甲状腺恶性结节的特异性高,可以作为诊断甲状腺恶性肿瘤的特征性表现。完整的环状钙化则多为甲状腺良性肿瘤的表现。小钙化和粗大钙化不能单独应用于甲状腺良恶性肿瘤的诊断,必须结合其他超声特征综合判断。

Objective To explore the value of calcification of thyroid nodules in the diagnosis of benign and malignant lesions. Methods 1 344 nodules of thyroid with ultrasound - guided core needle biopsy were analyzed retrospectively. Thyroid nodules were classified into different groups depended on different calcification. Results Among the 1 344 nodules,972 nodules were benign and 372 nodules were malignant. 744 nodule were calcification and 600 nodule were no calcification. The incidence of malignant nodules calcification（66. 13﹪）,the incidence of clus tered microcalcifications（72. 22﹪）and small calcification incidence（41. 94﹪）were higher than those of benign nodule（s P ﹤0. 01）. Calcifi cation diagnosis of benign and malignant thyroid nodules specificity and sensitivity were 66. 13﹪ and 48. 77﹪,positive predictive value and nega tive predictive value were 33. 06﹪ and 79. 00﹪. Clustered microcalcifications higher specificity,its specificity was 97. 94﹪,the sensitivity was 13. 98﹪,positive predictive value and negative predictive value were 72. 22﹪ and 74. 84﹪. Conclusion Micro - calcification of thyroid nodules has a better clinical value for ultrasonic diagnosis if benign and malignant lesions. The other kinds of calcifications were not so good.