三种超声征象及其联合应用在甲状腺乳头状癌中的诊断价值

The value of three ultrasonic features and the combination in diagnosing papillary thyroid carcinoma

目的:探讨三种超声征象及其联合应用对甲状腺乳头状癌(Papillary thyroid carcinoma,PTC)的诊断意义。方法:回顾性分析经手术病理证实的55例72枚PTC及18例28枚甲状腺良性结节(Benign thyroid nodules,BTN)的超声征象,包括纵横比≥1、边缘不规则和微钙化,计算三种超声征象及其联合应用诊断PTC的灵敏度、特异度、准确度。结果:纵横比≥1、边缘不规则和微钙化在PTC与BTN之间均具有统计学差异(P<O.05)。单项超声征象中,边缘不规则的灵敏度和准确度最高,均为93%;纵横比≥1的特异度最高,为100%。三种超声征象联合诊断的灵敏度和准确度最高,分别为97%和96%,高于任一单项和任意两种征象联合的灵敏度和准确度。结论:纵横比≥1、边缘不规则和微钙化这三种超声征象单独应用在PTC的诊断中具有较高的特异度,联合应用可提高灵敏度及准确度,提示这三种超声征象及其联合应用对PTC的术前诊断具有重要价值。

Objective To investigate the value of three ultrasonic features and the combination in diagnosing papillary thyroid carcinoma(PTC).Method The ultrasonic features comprising a taller-than-wide shape, irregular margins, and microcalcifications of 72 lesions in 55 cases of PTC and 28 lesions in 18 cases of benign thyroid nodules(BTN) which were confirmed by postoperative pathologic examination were analyzed retrospectively. The sensitivity, specificity and accuracy of three ultrasonic features and the combination in diagnosing PTC were obtained. Results A taller-than-wide shape, irregular margins, and microcalcifications showed statistically significant difference between PTC and BTN(P <0.05). The irregular margins showed the highest sensitivity(93%) and accuracy(93%), the taller-than-wide shape showed the highest specificity(100%), as compared to the other two ultrasonic features. Combining three ultrasonic features together showed the highest sensitivity(97%) and accuracy(96%), as compared to any single feature and any combition of two features. Conclusion Single ultrasonic feature shows a high sensitivity, the combination of different ultrasonic features can increase the sensitivity and accuracy, suggesting the important value of three ultrasonic features and the combination in preoperative diagnosis of PTC.