甲状腺超声影像报告联合甲状腺功能检测在甲状腺结节良恶性鉴别中的应用分析

Analysis of the application of thyroid ultrasound imaging report combined with thyroid function testing in the differential diagnosis of benign and malignant thyroid nodules

目的分析甲状腺超声(US)影像报告联合甲状腺功能(简称甲功)检测在甲状腺结节(TN)良恶性鉴别中的应用效果。方法选取2021年5月至2023年2月在本院就诊的170例TN患者,以术后病理穿刺结果为依据分成良性组(121例)和恶性组(49例)。所有患者均接受US检查,并通过化学发光法测定甲功检测指标[促甲状腺激素(TSH)、甲状腺球蛋白(TG)、降钙素(CT)、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPO-Ab)]。通过受试者工作特征(ROC)曲线分析甲功检测指标对TN的诊断效能,并以四格表对US联合甲功检测指标的诊断效能予以分析。结果良性组TG水平和恶性组相比明显更高(P<0.05),TSH、TGAb水平和恶性组相比明显更低(P<0.05);TSH水平和甲状腺癌患者TNM分期、淋巴结转移与否有关(P<0.05);TSH、TG、TGAb及US联合诊断TN良恶性的灵敏度为91.84%,准确度为79.41%,均高于四者单独诊断。结论TSH和甲状腺癌患者TNM分期、淋巴结转移与否有关,其联合TG、TGAb及US联合可提高对甲状腺癌的诊断效能。

Objective To analyze the application of thyroid ultrasound(US)imaging report combined with thyroid function testing in the differentiation of benign and malignant thyroid nodules(TN).Methods A total of 170 patients with TN who were hospitalized in our hospital from May 2021 to February 2023 were collected and grouped into benign group(n=121)and malignant group(n=49)based on postoperative pathological puncture results.All patients underwent US examination,and their thyroid function indicators[thyroid stimulating hormone(TSH),thyroglobulin(TG),calcitonin(CT),thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPO-Ab)]were measured by chemiluminescence method.The diagnostic efficacy of the thyroid function detection indicators for TN was analyzed using the receiver operator characteristic curve(ROC),and the diagnostic efficacy of the US combined thyroid function detection indicators was analyzed using a four-grid table.Results TG level in benign group was obviously higher than that in malignant group(P<0.05),while TSH and TGAb levels were obviously lower than those in the malignant group(P<0.05).TSH level was correlated with TNM stage and lymph node metastasis in patients with thyroid cancer(P<0.05),the sensitivity and accuracy of TSH,TG,TGAb,and US in the combined diagnosis of benign and malignant TN were 91.84%and 79.41%,all higher than those of the four alone.Conclusion TSH is related to TNM stage and lymph node metastasis in patients with thyroid cancer,and its combination with TG,TGAb,and US can improve the diagnostic efficacy of thyroid cancer.