US-FNAC及TSH、TPOAb 、TGAb水平在甲状腺囊实性结节定性诊断中的应用价值

doi:10.3969/j.issn.1671-7171.2023.11.012

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摘要【目的】探讨超声引导下甲状腺细针穿刺细胞学检查(US-FNAC)及促甲状腺素(TSH)、抗甲状腺过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体(TGAb)水平在甲状腺囊实性结节定性诊断中的应用价值。【方法】两院收治70例甲状腺囊实性结节患者均接受US-FNAC检查,分析US-FNAC诊断结果与病理检查结果的一致性;以病理结果作为诊断“金标准”,将70例患者分为良性组(n=43)与恶性组(n=27),比较两组患者血清TSH、TPOAb、TGAb水平;采用受试者工作特征(ROC)曲线分析以上指标单独和联合诊断恶性甲状腺囊实性结节的价值。【结果】US-FNAC定性诊断甲状腺囊实性结节的准确率为88.57%、灵敏度为92.59%、特异度为86.05%;恶性组血清TSH、TPOAb、TGAb水平均高于良性组(P<0.05);ROC分析证实:TSH、TPOAb、TGAb预测甲状腺囊实性结节患者定性为恶性的曲线下面积分别为0.681、0.794、0.618(均P<0.05);以US-FNAC恶性、TSH≥2.905 μU/mL、TPOAb≥10.050 IU/mL、TGAb≥32.285 IU/mL定义为阳性,联合诊断时任一结果为阳性则联合诊断视为阳性,经一致性分析证实,以上指标联合诊断的准确率为94.29%、灵敏度为96.30%、特异度为93.02%,明显高于US-FNAC单独诊断。【结论】US-FNAC及TSH、TPOAb、TGAb水平联合应用于甲状腺囊实性结节定性诊断中的准确率明显高于单独诊断,值得临床推广应用。

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	杨红梅
	王磊

关键词 ：甲状腺结节/诊断, 活组织检查,针吸, 促甲状腺素/血液, 甲状腺素结合球蛋白/血液

Abstract：【Objective】To explore the application value of ultrasound guided fine needle aspiration cytology(US-FNAC) and levels of thyroid stimulating hormone(TSH),anti thyroid peroxidase antibody(TPOAb),and anti thyroglobulin antibody(TGAb) in the qualitative diagnosis of thyroid cystic and solid nodules.【Methods】A total of 70 patients with thyroid cystic solid nodules admitted to both hospitals underwent US-FNAC examination,and the consistency between the US-FNAC diagnostic results and pathological examination results was analyzed; Using pathological results as the "gold standard" for diagnosis,70 patients were divided into a benign group(n=43) and a malignant group(n=27). The serum levels of TSH,TPOAb,and TGAb were compared between the two groups of patients; The value of the above indicators in the individual and combined diagnosis of malignant thyroid cystic solid nodules was analyzed through the receiver operating characteristic curve(ROC).【Results】The accuracy,sensitivity,and specificity of US-FNAC in qualitative diagnosis of thyroid cystic solid nodules were 88.57%,92.59%,and 86.05%,respectively; The serum TSH,TPOAb,and TGAb levels in the malignant group were higher than those in the benign group(P<0.05); After ROC analysis,it was confirmed that TSH,TPOAb,and TGAb predicted areas under the curve for patients with thyroid cystic solid nodules to be malignant,which were 0.681,0.794,and 0.618,respectively(all P<0.05); Malignant with US-FNAC,TSH ≥ 2.905 μU/mL,TPOAb≥10.050 IU/mL,and TGAb ≥ 32.285 IU/mL were defined as positive. When any result was positive in the combined diagnosis,the combined diagnosis was considered positive. Consistency analysis confirmed that the accuracy,sensitivity,and specificity of the combined diagnosis of the above indicators were 94.29%,96.30%,and 93.02%,significantly higher than those of US-FNAC alone.【Conclusion】The accuracy of the combined use of US-FNAC and TSH,TPOAb,and TGAb levels in the qualitative diagnosis of thyroid cystic solid nodules is significantly higher than that of individual diagnosis,and is worthy of clinical promotion and application.

Key words： Thyroid Nodule/DI Biopsy, Needle Thyrotropin/BL Thyroxine-Binding Globulin/BL

收稿日期: 2022-08-15

中图分类号:

R581

通讯作者: * E-mail:wanglei28250@163.com

引用本文:

杨红梅, 王磊. US-FNAC及TSH、TPOAb 、TGAb水平在甲状腺囊实性结节定性诊断中的应用价值[J]. 医学临床研究, 2023, 40(11): 1656-1659.
YANG Hongmei, WANG Lei. Application of US-FNAC and TSH,TPOAb,TGAb Levels in the Qualitative Diagnosis of Thyroid Cystic Solid Nodules. JOURNAL OF CLINICAL RESEARCH, 2023, 40(11): 1656-1659.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2023.11.012 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2023/V40/I11/1656

[1] NGUYEN D T,JIN K K,PHAM T D,et al. Ultrasound image-based diagnosis of malignant thyroid nodule using artificial intelligence[J].Sensors,2020,20(7):1-23.
[2] CHEN H,YE J,SONG J M,et al. Comparison of different ultrasound classification systems of thyroid nodules for identifying malignant potential:a cross-sectional study[J].Clinics,2021,76(2):e2126.
[3] 吴城炜,邹大中,缪伎玄,等. 超声引导下FNAC与ARHI印迹基因检测在甲状腺结节良恶性病变鉴别诊断中的比较研究[J].中国超声医学杂志,2019,35(10):877-879.
[4] 刘鹏,石宝刚,贺志强. 血清促甲状腺激素与甲状腺球蛋白比值对甲状腺功能正常者甲状腺结节良恶性的评估价值[J].中国地方病防治杂志,2020,35(6):688-693.
[5] 田文,孙辉,贺青卿. 超声引导下甲状腺结节细针穿刺活检专家共识及操作指南(2018版)[J].中国实用外科杂志,2018,38(3):6-9.
[6] TAN H W,LI Z H,LI N,et al. Thyroid imaging reporting and data system combined with Bethesda classification in qualitative thyroid nodule diagnosis[J].Medicine,2019,98(50):e18320.
[7] BERNA A,MUSTAFA S,CEYHAN K,et al. The influence of thyroid nodule size on the diagnostic efficacy and accuracy of ultrasound guided fine-needle aspiration cytology[J].Diag Cytopathol,2019,47(7):682-687.
[8] 任建陆,关海霞. 自身免疫性甲状腺病患者血清可溶TACI水平与甲状腺功能和抗体的相关性研究[J].重庆医科大学学报,2019,44(12):1558-1563.
[9] 薛蓉,刘亮,陈红天,等.ACRTI-RADS分类联合超声造影在甲状腺良恶性结节鉴别中的应用价值[J].医学临床研究,2019,36(12):2336-2340.
[10] 郑博文,李海凤,吴涛,等. 甲状腺结节细针穿刺活检假阳性诊断的细胞学及超声特征分析[J].中华超声影像学杂志,2021,30(12):1058-1063.
[11] 顾诗瑶,黄瑛. 应用超声引导下甲状腺细针穿刺技术比较四种临床指南的诊断效果[J].中国医学影像学杂志,2019,27(11):853-856.
[12] 周武琳,程晓明,吕俊远,等. 基于FNAB的分子检测技术在甲状腺结节诊断中的研究进展[J].中国普通外科杂志,2021,30(5):613-621.
[13] LUKA B,ANA B,SANDA G,et al. Genome-wide association analysis suggests novel loci underlying thyroid antibodies in Hashimoto's thyroiditis[J].Sci Rep,2019,9(1):5360.
[14] RESEARCH A,FRANCESCO M,ARTERO G H,et al.2021 immune-modulators and thyroid function in oncological patients with hashimotos thyroiditis[J].Cancer Sci,2021,4(2):2-3.