甲状腺乳头状癌的临床预测风险因素分析

Clinical predictive risk factors for papillary thyroid carcinoma

目的探讨甲状腺乳头状癌(PTC)患者的甲状腺功能、甲状腺结节超声特点及其诊断价值。方法收集我院收治的PTC患者(PTC组,147例)和良性甲状腺结节患者(良性结节组,328例)共475例的一般资料、甲状腺功能及甲状腺结节超声检查结果等,并进行比较分析。结果PTC组的男性患者比例、年龄、促甲状腺激素(TSH)水平及甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TgAb)阳性患者比例均明显高于良性结节组(P<0.05)。PTC组患者结节质地实性、低回声、边缘不规则、微钙化、纵横比>1、单发灶、TI-RADS分类≥4类比例及结节最大径均明显高于良性结节组(P<0.05)。Logistic回归分析结果示,年龄、TSH水平、结节低回声、边缘不规则、微钙化、最大径、单发灶、TI-RADS分类为PTC的临床预测因素(P<0.05)。结论年龄、TSH水平及甲状腺结节超声特点可能是PTC的临床预测风险因素。

Objective To investigate the thyroid function,the ultrasound characteristics of thyroid nodules of patients with papillary thyroid carcinoma(PTC)and their value of diagnosis of PTC.Methods The general data,thyroid function and the characteristics of the ultrasound results of the thyroid nodules of 475 patients with PTC(PTC group,n=147)and benign thyroid nodules(benign nodules group,n=328)diagnosed and treated in our hospital were collected and comparative analyzed.Results The proportion of male patients,age,thyroid stimulating hormone(TSH)level,the proportion of thyroid peroxidase antibodies(TPOAb)and thyroglobulin antibody(TgAb)-positive patients in the PTC group were significantly higher than those in the benign nodules group(P<0.05).The proportion of patients whose nodules were solid texture,hypoechoic,irregular edges,microcalcification,aspect ratio>1,single focus,TI-RADS classification≥4,and the maximum diameter of nodules in the PTC group were significantly higher than those in the benign nodules group(P<0.05).Logistic regression analysis showed that age,TSH level,nodular hypoechoic,irregular edges,microcalcification,maximum diameter,single focus,TI-RADS classification were clinical predictors of PTC(P<0.05).Conclusion Age,TSH level and ultrasonographic features of thyroid nodules may be clinical predictive risk factors of PTC.