常规灰阶超声评分和血清促甲状腺激素检测在单发性甲状腺结节性质诊断中的价值分析

Analysis of the Clinical Values of Conventional Grayscale Ultrasonographic Score and Serum Thyroid Stimulating Hormone Detection in the Diagnosis of Characteristics of Solitary Thyroid Nodules

目的:分析常规灰阶超声评分和血清促甲状腺激素(TSH)检测在单发性甲状腺结节性质诊断中的价值。方法:选取89例单发性甲状腺结节患者作为研究对象,其中,54例为恶性结节,35例为良性结节,对所有患者的术前常规灰阶超声评分和血清TSH水平进行观察和比较。结果:恶性结节组患者的常规灰阶超声评分和血清TSH水平均高于良好结节组,差异均有统计学意义(P<0.05);常规灰阶超声评分与血清TSH水平诊断恶性单发性甲状腺结节的AUC分别为0.634和0.932;Logistic多元回归分析结果显示常规灰阶超声评分、血清TSH水平均与恶性单发性甲状腺结节的发生具有独立相关性(Waldx^2=23.179、10.992,P<0.05),联合应用常规灰阶超声评分和血清TSH水平检测诊断恶性单发性甲状腺结节的AUC为0.900,95%置信区间为(0.833~0.967),在Cutoff值下的灵敏度和特异度分别为0.963和0.743。结论:常规灰阶超声评分在诊断甲状腺结节性质中具有一定的价值,将其与血清TSH水平检测进行联合应用时,可显著提高诊断的灵敏度。

Objective： To analyze the values of conventional grayscale ultrasonographic score and serum thyroid stimulating hormone （TSH） detection in the diagnosis of characteristics of solitary thyroid nodules. Methods： 89 cases of patients with solitary thyroid nodule were selected as the research objects, among them, 54 cases were with malignant nodules, 35 cases were with benign nodules. The preoperative conventional grayscale ultrasonographic scores and the serum TSH levels of all the patients were observed and compared. Results： The conventional ultrasonographic score and the serum TSH level of the patients in the malignant nodule group were higher than those in the benign nodule group, the differences were statistically significant （t=10.876, 2.848, P〈0.05）; AUC of the conventional grayscale ultrasonographic score and the serum TSH level in the diagnosis of malignant solitary thyroid nodule were 0.634 and 0.932 respectively; Logistic multiple regression analysis showed that the conventional grayscale ultrasonographic score or the serum TSH level was associated with the occurrence of malignant solitary thyroid nodule （Wald x^2=23.179, 10.992, P〈0.05）. AUC of combined application of the conventional grayscale ultrasonographic score and the serum TSH level detection in diagnosis of malignant solitary thyroid nodules was 0.900, 95% confidence intervals was 0.833-0.967. At the cutoff value, the sensitivity and the specificity were 0.963 and 0.743. Conclusions： The application of conventional grayscale ultrasonographic score in the diagnosis of quality of thyroid nodules has certain value, and the combined application of serum TSH level detection can significantly improve the diagnostic sensitivity.