超声造影联合细针穿刺活检对TI-RADS 4类甲状腺结节的诊断及结节性质与FPG、HbA1c水平的相关性分析<sup>*</sup>

doi:10.3969/j.issn.1671-7171.2024.09.011

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摘要【目的】探讨超声造影联合细针穿刺活检对TI-RADS 4类甲状腺结节的诊断价值,并分析结节性质与血清空腹血糖(FPG)和糖化血红蛋白(HbA1c)水平的相关性。【方法】选取2019年7月至2023年7月本院收治的351例TI-RADS 4类甲状腺结节患者,根据病理结果将患者分为恶性组(n=194)和良性组(n=157)。所有患者均进超声造影联合细针穿刺活检,比较两组患者血清FPG、HbA1c、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C)水平,分析超声造影联合细针穿刺活检对TI-RADS 4类甲状腺结节的诊断效果及其与FPG、HbA1c水平的相关性。【结果】超声造影检查的敏感度为84.3%,特异度为85.6%,准确度为85.4%,阳性预测值为95.5%,阴性预测值为62.4%。超声造影联合细针穿刺活检结节(联合检查)的敏感度为95.4%,特异度为87.9%,准确度为93.2%,阳性预测值为95.6%,阴性预测值为85.6%。联合检查的敏感度、准确度及阴性预测值高于超声造影检查,差异有统计学意义(P<0.05)。恶性组血清FPG、HbA1c水平高于良性组,差异有统计学意义(P<0.05);两组血清LDL-C、HDL-C、TG、TC水平比较,差异无统计学意义(P>0.05)。Pearson相关性分析显示,TI-RADS 4类甲状腺结节与患者的血清HbA1c、FPG水平呈正相关(r=0.821、0.800,均P<0.05)。【结论】超声造影联合细针穿刺活检对TI-RADS 4类甲状腺结节性质有较高诊断价值,且结节性质与患者血清FPG、HbA1c水平具有相关性。

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	李劲松
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关键词 ：甲状腺结节/影像诊断, 超声检查,介入性, 活组织检查,细针, 糖基化血红蛋白A, 血糖

Abstract：【Objective】To explore the diagnostic efficacy of contrast-enhanced ultrasound combined with fine-needle aspiration biopsy for TI-RADS 4 thyroid nodules, and investigate its association with levels of FPG and HbA1c. 【Methods】A total of 351 patients with TI-RADS 4 nodules from July 2019 to July 2023 were selected and divided into a malignant group (n=194) and a benign group (n=157) according to the pathological results. All patients underwent contrast-enhanced ultrasonography and fine-needle aspiration biopsy. The levels of serum FPG, HbA1c, total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were compared between the two groups of patients, and the diagnostic effect of ultrasound contrast-enhanced imaging combined with fine needle aspiration biopsy on TI-RADS 4 thyroid nodules and its correlation with FPG and HbA1c levels were analyzed.【Results】The sensitivity of ultrasound contrast examination was 84.3%, the specificity was 85.6%, the accuracy was 85.4%, the positive predictive value was 95.5%, and the negative predictive value was 62.4%. The sensitivity of ultrasound contrast combined with fine needle aspiration biopsy nodules (the combined examination) was 95.4%, the specificity was 87.9%, the accuracy was 93.2%, the positive predictive value was 95.6%, and the negative predictive value was 85.6%. The sensitivity, accuracy and negative predictive value of the combined examination were higher than those of ultrasound contrast examination alone, and the difference was statistically significant (P<0.05). The serum FPG and HbA1c levels in the malignant group were higher than those in the benign group, and the difference was statistically significant (P<0.05). There was no statistically significant difference in the serum LDL-C, HDL-C, TG, and TC levels between the two groups (P> 0.05). Pearson correlation analysis showed that TI-RADS 4 thyroid nodules were positively correlated with the patients' serum HbA1c and FPG levels (r=0.821, 0.800, both P<0.05).【Conclusion】 Ultrasound contrast imaging combined with fine needle aspiration biopsy has high diagnostic value for TI-RADS 4 nodules. The characteristic of the thyroid nodules is correlated with the patient's serum FPG and HbA1c levels.

Key words： Thyroid Nodule/DG Ultrasonography, Interventional Biopsy, Fine-Needle Glycated Hemoglobin A Blood Glucose

收稿日期: 2023-11-16

中图分类号:

R581

基金资助:* 陕西省重点研发计划项目(S2021-YF-YBSF-0426)

通讯作者: ** E-mail:tianxiulizheng@126.com

引用本文:

李劲松, 田秀丽. 超声造影联合细针穿刺活检对TI-RADS 4类甲状腺结节的诊断及结节性质与FPG、HbA1c水平的相关性分析^*[J]. 医学临床研究, 2024, 41(9): 1319-1321.
LI Jinsong, TIAN Xiuli. Contrast-Enhanced Ultrasonography Combined with Fine-Needle Aspiration Biopsy in Diagnosing TI-RADS 4 Thyroid Nodule and its Correlation with FPG and HbA1c Levels. JOURNAL OF CLINICAL RESEARCH, 2024, 41(9): 1319-1321.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2024.09.011 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2024/V41/I9/1319