天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (11): 1314-1317.doi: 10.11958/20160091

• 内分泌专题 • 上一篇    下一篇

TI-RADS 分级和 TSH∶Tg 比值鉴别甲状腺结节良恶性的研究

焦妍， 赵洪刚， 张遵城△   

  1. 天津医科大学第二医院核医学科 （邮编 300211）
  • 收稿日期:2016-03-01 修回日期:2016-08-28 出版日期:2016-11-15 发布日期:2016-11-15
  • 通讯作者: △通讯作者 E-mail：zhangzuncheng@sina.com E-mail:zhangzuncheng@sina.com
  • 作者简介:焦妍 （1983）， 女， 硕士在读， 主管技师， 主要从事内分泌疾病和肿瘤的实验室诊断研究

The combination of the TSH∶Tg ratio and TI-RADS for identification of benign and malignant thyroid nodules

JIAO Yan, ZHAO Honggang, ZHANG Zuncheng△   

  1. Department of Nuclear Medicine, The Second Hospital, Tianjin Medical University, Tianjin 300211, China
  • Received:2016-03-01 Revised:2016-08-28 Published:2016-11-15 Online:2016-11-15
  • Contact: △Corresponding Author E-mail：zhangzuncheng@sina.com E-mail:zhangzuncheng@sina.com

PDF (PC)

4548

摘要： 目的 评价 B 超甲状腺影像报告数据系统 （TI-RADS）分级和促甲状腺素 （TSH）∶甲状腺球蛋白 （Tg）比值对甲状腺结节良恶性的诊断效能。方法 选择 2015 年 1 月—12 月我院甲乳外科甲状腺结节手术患者 156 例， 经手术后病理诊断甲状腺乳头状癌患者 50 例， 良性甲状腺结节患者 106 例。计算患者 TSH∶Tg 比值， 采用受试者工作特征曲线 （ROC） 计算诊断切值， 检测值＜切值积 0 分， 检测值≥切值积 1 分。对 TI-RADS 分级进行量化， 3 级及以下、 4a、 4b、 4c、 5 级分别积 0、 1、 2、 3、 4 分。联用积分为 TSH∶Tg 比值积分和 TI-RADS 分级积分之和。结果 TSH∶Tg 比值鉴别甲状腺结节良恶性 ROC 曲线下面积 （AUC） 为 0.736， 敏感度、 特异度、 阳性预测值、 阴性预测值、 诊断符合率分为 64.0%、 82.1%、 62.7%、 82.8%、 76.3%。TI-RADS 分级积分鉴别甲状腺结节良恶性的 AUC 为 0.753， 敏感度、 特异度、 阳性预测值、 阴性预测值、 诊断符合率分为 84.0%、 72.6%、 59.2%、 90.6%、 76.3%。联用积分鉴别甲状腺结节良恶性的 AUC 为 0.839， 敏感度、 特异度、 阳性预测值、 阴性预测值、 诊断符合率分为 74.0%、 86.1%、 71.1%、 87.5%、 82.1%。结论 联用 TI-RADS 分级和 TSH∶Tg 比值鉴别甲状腺结节良恶性诊断效率优于单用一种方法， 且简便易行， 建议临床医师使用。

关键词: 甲状腺结节, 促甲状腺素, 甲状腺球蛋白, 甲状腺乳头状癌, 促甲状腺素, 甲状腺球蛋白比值, B 超甲状腺 影像报告数据系统

Abstract: Objective To assess the efficiency of thyroid stimulating hormone (TSH): thyroid globulin (Tg) ratio and ultrasound thyroid imaging reporting data system (TI-RADS) for thyroid nodule evaluation in euthyroid patients. Methods A total of 156 patients with thyroid nodules hospitalized in the department of thyroid breast surgery from January to December 2015 were included in this study. There were 50 patients were diagnosed as papillary thyroid carcinoma, and 106 patients were benign thyroid nodules confirmed by pathological diagnosis after operation. The ratio of TSH:Tg was calculated in patients. The cut- off point was calculated using the receiver operating characteristic (ROC) curve analysis. The measurement value < tangent was 0 point, and the measurement value ≥ tangent was 1 point. TI-RADS diagnostic criteria was evaluated and calculated. The nodule in TI- RADS categories 1, 2 and 3 was 0 points, The nodule in TI- RADS categories 4a, 4b, 4c, 5 was 1, 2, 3, 4 points, respectively . The combination score was the sum of the TSH:Tg ratio score and TI-RADS score. Results The area under the receiver operating characteristic curves of the TSH:Tg ratio was 0.736. The sensitivity, specificity, positive predictive value, negative predictive value, diagnose accordance rate were 64.0%, 82.1%, 62.7%, 82.8%, 76.3%, respectively. The AUC of TI-RADS was 0.753, the sensitivity, specificity, positive predictive value, negative predictive value, diagnose accordance rate were 84.0%, 72.6%, 59.2%, 90.6%, 76.3%, respectively. The AUC of the combination of the TSH:Tg ratio and TI-RADS was 0.839, the sensitivity, specificity, positive predictive value, negative predictive value, diagnose accordance rate were 74.0% , 86.1% , 71.1% , 87.5% , 82.1% , respectively. Conclusion The combination diagnosis of the TSH:Tg ratio and TI-RADS for thyroid nodule evaluation in euthyroid patients is better than that of only one method, which is worth clinical popularizing and application.

Key words: thyroid nodule, thyrotropin, thyroglobulin, papillary thyroid carcinoma, TSH, Tg ratio, TI-RADS