联合检测促甲状腺激素与甲状腺球蛋白在诊断甲状腺良恶性结节的临床价值
|
摘要
目的:分析联合检测促甲状腺激素(TSH)与甲状腺球蛋白(Tg)诊断甲状腺良、恶性结节的临床价值。方法:回顾性分析我院196例甲状腺结节(TN)患者临床资料,根据病理诊断结果分为恶性组(n=57)和良性组(n=139)。比较两组患者血清TSH、Tg水平差异,应用Logistic回归分析和受试者工作曲线(ROC曲线)评价TSH、Tg及二者联合诊断甲状腺良恶性结节的临床价值。结果:恶性组血清TSH、Tg水平高于良性组(P<0.05)。血清TSH水平ROC曲线显示AUC 0.739(P<0.05),临界值为2.45mIU/L,诊断灵敏度、特异度分别为0.754、0.770。血清Tg水平ROC曲线显示AUC 0.728(P <0.05),临界值为72.66ng/mL,诊断灵敏度、特异度分别为0.421、0.778。TSH联合Tg诊断AUC为0.815,敏感度、特异度分别为0.749、0.821,显著高于TSH、Tg各自单独诊断(P<0.05)。结论:联合检测TSH与Tg诊断甲状腺良恶性结节准确度、敏感度和特异度良好,具有一定临床价值。
Objective:To analyze the clinical value of combined detection of thyroid stimulating hormone(TSH) and thyroglobulin(Tg) in the diagnosis of benign and malignant thyroid nodules.Methods:The clinical data of 196 patients with thyroid nodules(TN) in our hospital were retrospectively analyzed.According to the results of pathological diagnosis,the patients were divided into malignant group(n = 57) and benign group(n = 139).Serum TSH and Tg levels were compared between the two groups.Logistic regression analysis and receiver operating curve(ROC curve) were used to evaluate the clinical value of TSH,Tg and the combined examination in the diagnosis of benign and malignant thyroid nodules.Results:Serum TSH and Tg levels in malignant group were higher than those in benign group(P < 0.05).The ROC curve of serum TSH level showed AUC was 0.739(P <0.05),and the critical value was 2.45 mIU/L,and the diagnostic sensitivity and specificity were 0.754 and 0.770 respectively.The ROC curve of serum Tg level showed AUC was 0.728(P <0.05),and the critical value was 72.66 ng/mL,and the diagnostic sensitivity and specificity were 0.421 and0.778 respectively.The AUC of TSH combined with Tg was 0.815,and the sensitivity and specificity were 0.749 and 0.821 respectively,and the above indexes were significantly higher than those of single TSH or Tg(P<0.05).Conclusions:The combined detection of TSH and Tg in the diagnosis of benign and malignant thyroid nodules has good accuracy,sensitivity and specificity,and has certain clinical value.
Objective:To analyze the clinical value of combined detection of thyroid stimulating hormone(TSH) and thyroglobulin(Tg) in the diagnosis of benign and malignant thyroid nodules.Methods:The clinical data of 196 patients with thyroid nodules(TN) in our hospital were retrospectively analyzed.According to the results of pathological diagnosis,the patients were divided into malignant group(n = 57) and benign group(n = 139).Serum TSH and Tg levels were compared between the two groups.Logistic regression analysis and receiver operating curve(ROC curve) were used to evaluate the clinical value of TSH,Tg and the combined examination in the diagnosis of benign and malignant thyroid nodules.Results:Serum TSH and Tg levels in malignant group were higher than those in benign group(P < 0.05).The ROC curve of serum TSH level showed AUC was 0.739(P <0.05),and the critical value was 2.45 mIU/L,and the diagnostic sensitivity and specificity were 0.754 and 0.770 respectively.The ROC curve of serum Tg level showed AUC was 0.728(P <0.05),and the critical value was 72.66 ng/mL,and the diagnostic sensitivity and specificity were 0.421 and0.778 respectively.The AUC of TSH combined with Tg was 0.815,and the sensitivity and specificity were 0.749 and 0.821 respectively,and the above indexes were significantly higher than those of single TSH or Tg(P<0.05).Conclusions:The combined detection of TSH and Tg in the diagnosis of benign and malignant thyroid nodules has good accuracy,sensitivity and specificity,and has certain clinical value.
引文
[1]王晓艳,王亚军,蒿花,等.甲状腺结节与代谢综合征相关组分的临床研究[J].西安交通大学学报(医学版),2017,38(1):151~153.
[2]朱精强,苏安平.甲状腺结节手术治疗的合理选择[J].中国实用外科杂志,2015,35(6):635~639.
[3]张文清,胡宴宾,李学农,等.CT联合高分辨率超声检查在肿瘤性甲状腺结节中的影像学表现及其诊断价值分析[J].河北医学,2015,21(10):1623~1626.
[4]Grant EG,Tessler FN,Hoang JK,et al.Thyroid ultrasound reporting lexicon:white paper of the ACR thyroid Imaging,reporting and data system(TIRADS)committee[J].Am Coll Radiol,2015,12(12):1272~1279.
[5]计玉芳.甲状腺超声检查联合甲状腺功能指标在良恶性甲状腺结节中的诊断价值[J].医学临床研究,2015,32(12):2330~2333.
[6]于钏钏,王强.2008-2014年我国健康成人甲状腺结节流行特征及影响因素初步分析[J].环境与健康杂志,2016,33(5):440~443.
[7]贾学明,张林江.彩色多普勒超声血流显像及造影增强模式在甲状腺良恶性结节鉴别诊断中的价值分析[J].河北医学,2015,21(12):1940~1943.
[8]虞卫,许俊姿.术前TSH水平与甲状腺结节性质的关系[J].中国现代手术学杂志,2016,20(6):415~417.
[9]Choi JS,Nam CM,Kim EK,et al.Evaluation of serum thyroid-stimulating hormone as indicator for fine-needle aspiration in patients with thyroid nodules[J].Head Neck,2015,37(4):498~504.
[10]程田,唐振林.胸苷激酶1和甲状腺球蛋白检测对鉴别甲状腺结节良恶性的价值[J].中国肿瘤临床,2018,45(9):445~448.
[11]Trimboli P,Treglia G,Giovanella L.Preoperative measurement of serum thyroglobulin to predict malignancy in thyroid nodules:a systematic review[J].Horm Metab Res,2015,47(4):247~252.
[12]潘东升,鲁来兴,冯宝兴.应用logistic回归和ROC曲线评价甲状腺球蛋白及其抗体对甲状腺癌和良性甲状腺结节的鉴别诊断[J].中国卫生检验杂志,2015,25(11):1799~1801.
[2]朱精强,苏安平.甲状腺结节手术治疗的合理选择[J].中国实用外科杂志,2015,35(6):635~639.
[3]张文清,胡宴宾,李学农,等.CT联合高分辨率超声检查在肿瘤性甲状腺结节中的影像学表现及其诊断价值分析[J].河北医学,2015,21(10):1623~1626.
[4]Grant EG,Tessler FN,Hoang JK,et al.Thyroid ultrasound reporting lexicon:white paper of the ACR thyroid Imaging,reporting and data system(TIRADS)committee[J].Am Coll Radiol,2015,12(12):1272~1279.
[5]计玉芳.甲状腺超声检查联合甲状腺功能指标在良恶性甲状腺结节中的诊断价值[J].医学临床研究,2015,32(12):2330~2333.
[6]于钏钏,王强.2008-2014年我国健康成人甲状腺结节流行特征及影响因素初步分析[J].环境与健康杂志,2016,33(5):440~443.
[7]贾学明,张林江.彩色多普勒超声血流显像及造影增强模式在甲状腺良恶性结节鉴别诊断中的价值分析[J].河北医学,2015,21(12):1940~1943.
[8]虞卫,许俊姿.术前TSH水平与甲状腺结节性质的关系[J].中国现代手术学杂志,2016,20(6):415~417.
[9]Choi JS,Nam CM,Kim EK,et al.Evaluation of serum thyroid-stimulating hormone as indicator for fine-needle aspiration in patients with thyroid nodules[J].Head Neck,2015,37(4):498~504.
[10]程田,唐振林.胸苷激酶1和甲状腺球蛋白检测对鉴别甲状腺结节良恶性的价值[J].中国肿瘤临床,2018,45(9):445~448.
[11]Trimboli P,Treglia G,Giovanella L.Preoperative measurement of serum thyroglobulin to predict malignancy in thyroid nodules:a systematic review[J].Horm Metab Res,2015,47(4):247~252.
[12]潘东升,鲁来兴,冯宝兴.应用logistic回归和ROC曲线评价甲状腺球蛋白及其抗体对甲状腺癌和良性甲状腺结节的鉴别诊断[J].中国卫生检验杂志,2015,25(11):1799~1801.