分化型甲状腺癌诊断方法的临床流行病学评价

Clinic epidemiological evaluation of diagnosis methods of differentiated thyroid carcinoma

目的对甲状腺患者诊断方法进行临床流行病学分析,评估各种诊断方法在分化型甲状腺癌诊断中的意义、优势,对临床合理使用这些方法提供参考。方法整理分析了2014年1月1日—12月31日期间因甲状腺疾病于青岛大学附属医院就诊并行手术切除治疗患者205例,依据术后常规病理结果作为金标准,分别对病史和触诊、超声、超声引导性细针穿刺活检、CT、术中快速冰冻病理诊断进行流行病学统计,运用四格表进行运算、分析和评价。结果病史和触诊、超声、超声引导性细针穿刺活检、CT、术中快速冰冻病理诊断甲状腺癌的灵敏度分别为78.95%、83.15%、88.67%、74.28%、99.47%,特异度分别为60%、75%、80%、71.4%、100%。结论目前对于分化型甲状腺癌的术前良、恶性诊断,缺乏有效和确切的手段,需要根据患者具体病情选用合理的诊断方法。

Objective To conduct clinical epidemiological analyses of diagnosis methods for patients with thyroid cancer, and to evaluate the significance and advantages of various diagnosis methods and offer reference of clinical rational use of these methods. Method A total of 205 patients withthyroid diseases who received treatment and resection operations in Affiliated Hospital of Qingdao University Medical College from January 1st, 2014 to December 31 st, 2014 were selected and analyzed. Based on the golden standard of postoperation conventional pathological results, an epidemiology statistic of various diagnosis methods was made, including the epidemiological statistics of history & palpation, ultrasonography, ultrasonography guided fine needle aspiration, CT and intraoperative rapid frozen pathology. Four fold table was used to calculate, analyze and evaluatethe results. Results For thyroid carcinoma, the diagnosis sensitivity of medical history & palpation, ultrasonography, ultrasonography guided fine needle aspiration, CT and intraoperative rapid frozen pathology was 78.95%, 83.15%, 88.67%, 74.28% and99.47%, respectively;the specificity of them was 60%, 75%, 80%, 71.4% and 100%, respectively. Conclusions There is lack of effective and precise means to diagnose before operation whether the differentiated thyroid nodule is benign or malignant. Reasonable diagnosis method should be chosen according to the patient's actural condition.