甲状腺结节恶性危险因素分析及预测模型建立

Analysis of malignant characteristics of thyroid nodules and predictive equation making

目的研究分析甲状腺结节的恶性独立危险因素。方法选取2015年1月至2017年3月经手术病理证实的甲状腺结节作为研究对象。采用单因素分析和二元多因素回归分析找出独立危险因素,建立回归预测方程并绘制受试者工作曲线(ROC曲线)。结果共1 351个结节最后入组。回归预测方程P=1/1+Exp∑[-2.357+1.218×(if实性成分)+2.226×(if低回声)+1.741×(if有微小钙化)+1.990×(if纵横比≥1)+1.859×(if边缘不规则)+0.425×(if异常淋巴结)],绘制ROC曲线得出曲线下面积(AUC)为0.922。结论年龄小、实性成分、(极)低回声、边缘不规则、细小钙化、纵横比≥1、异常淋巴结为甲状腺恶性结节的独立危险因素,危险因素越多,恶性可能越大。

Objective To explore the malignant risk factors of thyroid nodules.Methods From January 2015 to March2017,patients with thyroid nodules confirmed by pathology after surgery in our hospital were enrolled.Patient age,sex and ultrasound features were recorded.Univariate analysis and binary multivariate logic regression analysis were applied to analyze the possible risk factors associated with malignancy.Results A total of 1 351 nodules were enrolled.A binary multivariate logistic regression predictive equation was set up,P=1/1＋Exp ∑ [-2.357＋1.218×（if solid component）＋2.226×（if hypohypo-echogenicity）＋1.741×（if micro-calcification）＋1.990×（if anteroposterior to transverse ratio≥1）＋1.859×（if ill-margined）＋0.425×（if abnormal lymph nodes）],and receiver operating characteristic（ROC）was drew with area under the curve（AUC）of 0.922.Conclusion Younger patient age,nodule solid component,hypo-echo,irregular margin,microcalcification,aspect ratio≥1,and abnormal lymph nodes were predictive risk factors for malignant thyroid nodules,the more risk factors,the more likely it is malignant.