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超声检查对甲状腺微小乳头状癌诊断价值的探讨

  

  1. 辽河油田总医院 功能科,辽宁 盘锦 124010
  • 出版日期:2019-04-20 发布日期:2019-05-16
  • 通讯作者: 杜鹃, Email: dujuan72@163.com

The value of ultrasonography in the diagnosis of papillary thyroid Microcarcinoma

  1. Departmentof Function, Liaohe Oilfield General Hospital, Panjin  124010, China
  • Online:2019-04-20 Published:2019-05-16
  • Contact: Corresponding author:Du Juan, Email: dujuan72@163.com

摘要: 目的  分析甲状腺微小乳头状癌(papillary thyroid microcarcinoma,  PTMC)的超声声像图特征,并研究其对PTMC的临床诊断价值。方法  回顾性研究2015年1月至2018年9月间在我院行超声检查并经手术病理证实的≤1 cm的甲状腺结节患者203例,其中PTMC 103例,甲状腺良性结节100例,分析其声像图差异。根据病理结果,应用受试者工作特征曲线和曲线下面积(area under curve,  AUC)评估超声对PTMC的诊断效能。结果  PTMC和甲状腺良性结节在结节回声、囊实性、微钙化、纵横比、边界、边缘和声晕方面差异有统计学意义(P<0.05)。超声检查对PTMC显示了较好的诊断价值,AUC为0.88(95%CI:0.840.93)。以TIRADS4为截断点时,超声对PTMC诊断的敏感度、特异度、准确性、阳性预测值和阴性预测值分别是85.4%、75.0%、80.2%、77.8%和83.3%。结论  PTMC在声像图上有其特征性表现,超声检查对PTMC有较好的临床诊断价值。

关键词: 甲状腺肿瘤, 甲状腺乳头状癌, 超声检查

Abstract: Objective  To analyze the ultrasonographic features of papillary thyroid Microcarcinoma (PTMC) and to evaluate its clinical diagnostic value for PTMC. Methods  A retrospective study of 203 patients with thyroid nodules ≤1 cm confirmed by ultrasonography and surgical pathology was established in our hospital from January 2015 to September 2018, including 103 cases of PTMC and 100 cases of benign thyroid nodules. The sonographic differences of benign and malignant thyroid nodules were analyzed. According to the pathological results, the receivers' operating characteristic  curve (ROC) and the area under curve (AUC) were used to evaluate the diagnostic efficacy of ultrasound on PTMC. Results  Nodular echo, cystic solidity, microcalcification, aspect ratio, border, margin, and acoustic halos were significantly different between PTMC and benign thyroid nodules (P<0.05). Ultrasonography showed good diagnostic value for PTMC with an AUC of  0.88(95%CI: 0.840.93). When TI RADS4 was used as the cutting point, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of ultrasound for PTMC diagnosis were 85.4%, 75.0%, 80.2%, 77.8% and 83.3%, respectively. Conclusion  PTMC has characteristic features on sonograms. Ultrasonography has a good clinical diagnostic value for PTMC.

Key words: thyroid neoplasms, papillary thyroid carcinoma, ultrasonography