良恶性甲状腺结节临床特征的比较分析

Comparative analysis of clinical features of benign and malignant thyroid nodules

目的 探讨甲状腺恶性肿瘤的相关危险因素,为甲状腺结节性质的判别提供依据。方法 选取兰州大学第二医院2018年6月至2020年1月因甲状腺结节行手术治疗的337例患者,根据病理结果,分为良性结节组和恶性结节组;分析两组患者的临床资料,探讨甲状腺恶性肿瘤的相关危险因素。结果 (1)恶性结节组患者的平均年龄、结节的纵径和横径小于良性结节组患者(P<0.001);(2)恶性结节组患者的血清促甲状腺素(thyrotropin,TSH)、甲状腺球蛋白抗体(thyroglobulin antibody,TgAb)、甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)升高比例高于良性结节组;甲状腺球蛋白(thyroglobulin,TG)升高比例低于良性结节组(P<0.01);(3)恶性结节组患者的颈部淋巴结增大、结节内低回声、结节纵横比>1、形态欠规则或不规则、边界欠清晰或不清晰的发生率高于良性结节组(P<0.05);(4)二元Logistic回归分析提示:低回声、有钙化、形态欠规则或不规则、纵横比>1、边界欠清晰或不清晰是恶性结节的危险因素;年龄每增加1岁,恶性结节患病率下降5.4%(P<0.05)。结论 超声提示低回声、有钙化、形态欠规则或不规则、纵横比>1、边界欠清晰或不清晰是甲状腺癌的危险因素;年龄与甲状腺癌患病风险呈负相关。

Objective To explore the relevant risk factors of thyroid malignant tumor and provide basis for distinguishing the nature of thyroid nodules.Methods A total of 337 patients who underwent surgical treatment for thyroid nodules at the Second Hospital of Lanzhou University from June 2018 to January 2020 were selected,according to the pathological results,the patients were divided into benign nodule group and malignant nodule group.Clinical data of the two groups of patients were analyzed to explore the relevant risk factors for thyroid malignant tumors.Results①The average age,longitudinal and transverse diameters of malignant nodule group were smaller than those of benign nodule group(P<0.001);②The proportion of patients with elevated serum thyrotropin(TSH),thyroglobulin antibody(TgAb),and thyroid peroxidase antibody(TPOAb)in malignant nodule group were higher than those in benign nodule group;The proportion of thyroglobulin(TG)elevation was lower than in benign nodule group(P<0.01);③The incidence of neck lymph node enlargement,low echogenicity within the nodule,nodule aspect ratio>1,irregular or irregular morphology,and unclear boundaries in malignant nodule group were higher than those in benign nodule group(P<0.05);④Binary Logistic regression analysis suggests that low echogenicity,calcification,irregular or irregular morphology,aspect ratio>1,and unclear or unclear boundaries were risk factors for malignant nodules;For every year of age increase,the incidence of malignant nodules decreases by 5.4%(P<0.05).Conclusion Ultrasound prompts low echo,calcification,irregular or irregular morphology,aspect ratio>1,and unclear or unclear boundaries are risk factors for thyroid cancer;Age is negatively correlated with the risk of thyroid cancer.