摘要
目的 分析TI-RADS分级对于不同病理类型甲状腺癌的诊断价值。方法 随机选取2012年8月—2018年8月该院甲状腺病变患者712例,分析712例甲状腺结节患者的TI-RADS分级情况,统计分析不同病理类型甲状腺癌诊断中改良TI-RADS分级的诊断价值、超声声像图特征。结果 712例患者中,在TI-RADS分级方面,10例为1级,98例为2级,94例为3级,128例为4a级,190例为4b级,130例为4c级,62例为5级,分别占总数的1.4%、13.8%、13.2%、18.0%、26.7%、18.3%、8.7%。甲状腺恶性病变诊断中改良TI-RADS分级的诊断敏感度、特异度、准确度、阳性预测值、阴性预测值分别为84.0%、66.7%、88.6%、57.4%、79.8%,其中MTC、PTC诊断中TI-RADS分级的诊断敏感度、阳性预测值、阴性预测值均显著高于FTC (χ~2=11.14,12.83,13.34,14.45,16.01,17.74,P<0.05),PTC诊断中TI-RADS分级的诊断准确度显著高于MTC、FTC(χ~2=11.34,13.28,P<0.05),但MTC、PTC、FTC诊断中诊断中TI-RADS分级的诊断特异度之间的差异无统计学意义(χ~2=1.32,0.86,0.76,P>0.05)。MTC和PTC患者结节位置之间的差异有统计学意义(χ~2=6.63,P<0.05),MTC和PTC、PTC和FTC患者结节边界、回声类型之间的差异有统计学意义(χ~2=9.21,11.25,12.32,P<0.05),MTC和PTC、MTC和FTC、PTC和FTC患者结节形态、血供情况之间的差异有统计学意义(F=13.52,P<0.05),MTC和PTC、MTC和FTC患者的淋巴结转移之间的差异有统计学意义(χ~2=13.53,P<0.05),但MTC和PTC、MTC和FTC、PTC和FTC患者结节性质、病灶钙化之间的差异无统计学意义(χ~2=0.42,P>0.05)。结论 TI-RADS分级对于不同病理类型甲状腺癌的诊断价值低,但对于甲状腺恶性病变的诊断价值高。
Objective Diagnostic value of TI-RADS classification for different pathological types of thyroid cancer. Methods A total of 712 patients with thyroid lesions were randomly selected from August 2012 to August 2018, and the TI-RADS classification of 712 patients with thyroid nodules were analyzed. The diagnostic value of improved TI-RADS grade in the diagnosis of thyroid carcinoma with different pathological types was analyzed statistically. Results In terms of TI-RADS classification, 10 cases were grade 1, 98 cases were grade 2, 94 cases were grade 3, 128 cases were grade 4a, 190 cases were grade 4b, 130 cases were grade 4C and 62 cases were grade 5, accounting for 1.4%, 13.8%, 13.2%, 18.0%, 26.7%, 18.3% and 8.7%, respectively. The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value of improved TI-RADS grading in the diagnosis of thyroid malignant lesions were 84.0%, 66.7%, 88.6%, 57.4%, 79.8%, respectively. The diagnostic sensitivity, positive predictive value and negative predictive value of TI-RADS grading in the diagnosis of MTC and PTC were significantly higher than those of FTC (χ^2=11.14, 12.83,13.34, 14.45, 16.01, 17.74, P<0.05). The diagnostic accuracy of TI-RADS classification in C diagnosis was significantly higher than that of MTC and FTC (χ^2=11.34, 13.28, P<0.05). The diagnostic specificity of TI-RADS classification in MTC, PTC and FTC diagnosis was not significantly different (χ^2=1.32, 0.86, 0.76, P>0.05). There were significant differences in nodule location between MTC and PTC patients (χ^2=6.63, P<0.05). There were significant differences in nodule boundary and echo types between MTC and PTC, PTC and FTC patients (χ^2=9.21, 11.25, 12.32, P<0.05). There were significant differences in nodule shape and blood supply between MTC and PTC, FTC, PTC and FTC patients (F=13.52, P<0.05), and the difference between lymph node metastasis in patients with MTC and PTC, MTC and FTC was significant (χ^2=13.53, P<0.05). But the difference between MTC and PTC, MTC and FTC, PTC and FTC was not significant (χ^2=0.42, P>0.05). Conclusion The diagnostic value of TI-RADS grade for thyroid carcinoma of different pathological types is low, but it is high for malignant thyroid lesions.
作者
刘博文
武敏
葛丽霞
许瑞霞
桑志萍
LIU Bo-wen;WU Min;GE Li-xia;XU Rui-xia;SANG Zhi-ping(Shanxi Provincial Institute of Endemic Diseases Prevention and Treatment,Linfen,Shanxi Province,041000 China)
出处
《世界复合医学》
2019年第3期4-6,17,共4页
World Journal of Complex Medicine
