健康体检者中桥本甲状腺炎超声及血清免疫学检查与病理对照分析

Comparison of ultrasound and serum immunological examination and pathology of hashimoto's thyroiditis in health examination

目的探讨健康体检者中桥本甲状腺炎的超声及血清免疫学检查与病理结果之间的一致性。方法选取我院体检中心进行常规体检的人群中,经超声诊断及血清免疫学检查结果,并进行手术治疗的546例临床及超声资料。评估桥本甲状腺炎的超声及血清学指标与病理结果之间的一致性。结果546例经手术治疗的患者中,218例经病理证实为桥本甲状腺炎。超声检查及血清抗过氧化物酶抗体(TPO-Ab)的敏感性、特异性、阳性预测值、阴性预测值、约登指数分别为49.1%、85.7%、69.5%、71.7%、34.8%与61.5%、87.2%、76.1%、77.3%、48.7%。一致性分析表明,对于诊断桥本甲状腺炎,TPOAb与组织病理学的一致性(kappa=0.50)要比超声与组织病理学的一致性(kappa=0.37)高。结论超声与血清学标记物是筛查桥本甲状腺炎的有效检查方法。

Objective To investigate the consistency between ultrasound and serum immunological examination and pathological results of Hashimoto's thyroiditis in healthy subjects.Methods The clinical and ultrasonic data of 546 cases were collected by ultrasound diagnosis and serum immunological examination.We evaluated the consistency between Hashimoto's thyroiditis ultrasound and serological indicators and pathological results.Results Among the 546 surgically treated patients,218 were confirmed by pathology as Hashimoto's thyroiditis.The sensitivity,specificity,positive predictive value,negative predictive value,and Yoden index of ultrasound examination and TPO-Ab were 49.1%,85.7%,69.5%,71.7%,34.8%and 61.5%,87.2%,76.1%,77.3%,48.7%.Consistency analysis showed that for the diagnosis of Hashimoto's thyroiditis,the consistency of TPOAb and histopathology(kappa=0.50)was higher than that of ultrasound and histopathology(kappa=0.37).Conclusion Ultrasound and serological markers are effective methods for screening Hashimoto's thyroiditis.