摘要
的应用二分类Logistic回归分析甲状腺结节超声检查各指标对鉴别结节良恶性的意义.方法收集经手术切除后病理证实的240例甲状腺结节,其中良性结节173例作为对照组,恶性结节67例作为观察组.收集甲状腺结节的超声声像图特征,比较两组超声特征行单因素X2检验,对组间比较有统计学意义的变量,建立二分类Logistic回归模型,绘制ROC曲线并计算曲线下面积.结果观察组与对照组甲状腺结节超声检查在边界、纵横比、形态、回声水平、钙化、晕环、颈部淋巴结肿大等方面比较,差异均有统计学意义（X2=45.392、7.590、30.039、24.168、37.406、6.893、16.078,均P〈0.01）.对有统计学意义的指标经过二分类Logistic分析,共有边界（P=0.000,OR=8.437）、纵横比（P=0.000,OR=12.816）、微钙化（P=0.000,OR=8.893）、形态（P=0.000,OR=8.791）、显著低回声（P=0.001,OR=8.313）、颈部淋巴结肿大（P=0.001,OR=6.891）6个变量进入回归方程,该模型对甲状腺恶性结节预报的正确率为90.7%（223/246）,ROC曲线下面积为0.904±0.031.结论二分类Logistic回归分析能筛选出鉴别甲状腺结节良恶性最具意义的超声特征,该模型诊断准确度较高,具有临床实用性.
Objective To evaluate the clinical value of ultrasonography in diagnosis of benignPHand malignant thyroid nodules by binary Logistic regression model.Methods A retrospective analysis of 240 cases of thyroid nodules confirmed by pathology after operation excision was conducted.173 nodules were benign as control group,67 nodules were malignant as observation group.The ultrasonic features of thyroid nodules were collected.The factor had statistics significance by x2 test between the two groups were analyzed by binary Logistic regression.A logistic regression model was created.The ROC curve was drawn and the area under the curve was calculated.Results There were statistically significant differences among boundary,aspect ratio,shape,internal echo,calcification,acoustic halo,cervical lymphadenectasis between the control group and observation group（x2=45.392,7.590,30.039,24.168,37.406,6.893,16.078,all P〈0.01）.And after Logistic regression analysis,six variables that entered the regression equation were boundary（P=0.000,OR=8.437）,aspect ratio（P=0.000,OR=12.816）,microcalcification of the nodules（P=0.000,OR=8.893）,shape（P=0.000,OR=8.791）,internal echoes（P=0.001,OR=8.313）and cervical lymphadenectasis（P=0.001,OR=6.891）.The accuracy of the model was 90.7%（223/246）in predicting malignant nodules in thyroid.The area under the ROC curve was（0.904±0.031）.Conclusion The binary Logistic regression can be used to differentiate malignant and benign thyroid nodules,and make a more accurate judgment for the nodules in thyroid.
出处
《中国基层医药》
CAS
2017年第16期2464-2468,J0004,共6页
Chinese Journal of Primary Medicine and Pharmacy
关键词
甲状腺结节
超声检查
诊断
鉴别
Thyroid nodule
Ultrasonography
Diagnosis, differentials
