C-TIRADS联合血常规炎性参数鉴别甲状腺结节良恶性的应用价值

The Clinical Value of C-TIRADS Combined with Routine Blood Inflammatory Parameters in Distinguishing Benign and Malignant Thyroid Nodules

目的探讨超声C-TIRADS分级联合血常规炎性参数在鉴别甲状腺结节良恶性中的应用价值。方法纳入2023年1月至12月于我院行甲状腺结节手术切除的患者117例作为研究对象,并依据其病理结果划分为良性组(49例)与恶性组(68例)。收集和对比两组年龄、性别等临床资料与C-TIRADS分级、PLR、NLR、SII、SIRI等检验检查结果,采用Logistic回归和ROC曲线分析C-TIRADS联合上述炎性参数与甲状腺结节良恶性的关系及鉴别效能。结果两组患者在性别、年龄、维生素D缺乏症等伴发病症以及糖尿病等既往病史方面差异均无统计学意义(P>0.05);恶性组患者C-TIRADS 4类及以上比例、PLR、NLR、SII、SIRI均显著高于良性组(P<0.05),且是甲状腺恶性结节的风险因子(OR>1,P<0.05),但两组间LMR差异无统计学意义;C-TIRADS(AUC=0.755)与PLR、NLR、SII、SIRI联合应用时诊断效能均有所升高(AUC=0.788、0.791、0.829、0.799);PLR、NLR、SII、SIRI未显示与颈部淋巴结转移的相关性。结论术前C-TIRADS联合PLR、NLR、SII、SIRI均可提高甲状腺结节良恶性诊断的效能,后者可以在无创筛查和鉴别甲状腺结节性质时作为超声检查的有益补充。

Objective To explore the diagnostic efficacy of C-TIRADS combined with NLR,PLR,LMR,SII,or SIRI in distinguishing between benign and malignant thyroid nodules.Methods A total of 117 patients,who underwent thyroid nodule surgery in our hospital from January,2023 to December,2023,were collected as the research objects.According to the pathological results,49 patients with benign thyroid nodules were selected as the benign group,while 68 patients with papillary thyroid carcinoma were considered as the malignant group.The basic patient information,C-TIRADS,and the aforementioned inflammatory parameters of the two groups were compared to evaluate the efficacy of C-TIRADS combined with the inflammatory parameters in distinguishing thyroid nodules.Results There were no statistically significant differences in gender,age,comorbidities such as vitamin D deficiency,and past medical history of diabetes between the two groups(P>0.05).The proportion of C-TIRADS 4 classes and above,PLR,NLR,SII,and SIRI in the malignant group were significantly higher than those in the benign group(P<0.05),and these markers were identified as risk factors for thyroid malignant nodules(OR>1,P<0.05),but there was no statistical difference in LMR between the two groups.When C-TIRADS was combined with PLR,NLR,SII,or SIRI,the diagnostic efficacy increased(AUC=0.788,0.791,0.829,0.799)compared to C-TIRADS alone(AUC=0.755);PLR,NLR,SII,and SIRI showed no correlation with cervical lymph node metastasis.Conclusion Pre-operative C-TIRADS combined with PLR,NLR,SII,or SIRI can improve the efficacy of distinguishing between benign and malignant thyroid nodules,and the latter can serve as a beneficial supplement method to ultrasound examination in identifying characteristics of thyroid nodules.