血小板参数用于甲状腺良恶性结节鉴别诊断的价值研究

Value of Platelet Parameters in Differential Diagnosis of Benign and Malignant Thyroid Nodules

目的:探讨血小板参数在甲状腺良恶性结节鉴别诊断中的应用价值。方法:选取2020年1月—2021年12月青岛市黄岛区区立医院收治具备手术指征的46例甲状腺结节患者作为研究对象,回顾性分析患者的临床病理资料,收集患者血小板计数(PLT)、血小板分布宽度(PDW)、大血小板比率(P-LCR)、淋巴细胞计数,并计算血小板/淋巴细胞比值(PLR),评估血小板相关参数在甲状腺良恶性结节鉴别诊断中的应用价值。绘制PLR的ROC曲线并计算曲线下面积,根据约登指数计算出最合理的临界值和对应的敏感度、特异度。结果:甲状腺癌(观察组)患者PLT和P-LCR较结节性甲状腺肿(对照组)高,差异有统计学意义(F=1.747、0.742,P<0.05),观察组患者PDW较对照组高,差异无统计学意义(F=1.508,P>0.05)。观察组患者PLR高于对照组,差异有统计学意义(F=5.060,P<0.05)。PLR的ROC曲线下面积为0.713,敏感度为0.696,特异度为0.609,cut-off值为124.5。结论:术前外周血PLT、P-LCR、PLR对于甲状腺癌和结节性甲状腺肿的鉴别诊断具有一定的指导意义。

Objective:To investigate the application value of platelet parameters in differential diagnosis of benign and malignant thyroid nodules.Methods:A total of 46 patients with thyroid nodules admitted to Huangdao District Hospital of Qingdao from January 2020 to December 2021 with indications for surgery were enrolled.The clinicopathological data of the patients were retrospectively analyzed.Platelet count(PLT),platelet distribution width(PDW),large platelet ratio(P-LCR)and lymphocyte count were collected.The platelet/lymphocyte ratio(PLR)was calculated to evaluate the value of platelet related parameters in the differential diagnosis of benign and malignant thyroid nodules.The ROC curve of PLR were drawn,and the area under the curve was calculated.The optimal critical value(cutoff-value)and the corresponding sensitivity and specificity were calculated according to the Youdan index.Results:PLT and P-LCR of patients with thyroid cancer(observation group)were higher than those with nodular goiter(control group),and the difference was statistically significant(F=1.747,0.742,P<0.05).PDW of the observation group was higher than that of the contralateral group,and the difference was not statistically significant(F=1.508,P>0.05).PLR in the observation group was higher than that in the control group,and the difference was statistically significant(F=5.060,P<0.05).The area of PLR under the ROC curve was 0.713,with the sensitivity of 0.696,the specificity of 0.609,and the cutoff value of 124.5.Conclusion:Preoperative peripheral blood PLT,P-LCR and PLR have certain value in the differential diagnosis of thyroid carcinoma and nodular goiter.