钙化超声特征联合甲状腺功能对甲状腺结节性质评估OA
Value of ultrasound features of calcification combined with thyroid function in assessing the nature of thyroid nodules
目的 探讨不同超声钙化特征联合血清促甲状腺激素(TSH)、游离甲状腺素/游离三碘甲状腺原氨酸(FT4/FT3)比值对甲状腺结节良恶性的评估价值.方法 回顾性纳入2023年6月-2025年5月河南省肿瘤医院110例甲状腺结节病人,依据病理结果分为良性组(68例)与恶性组(42例),比较两组一般资料、超声钙化特征及甲状腺功能指标,通过受试者工作特征(ROC)曲线下面积(AUC)评估诊断效能.结果 恶性组的女性构成比更高,且平均结节直径更大(x2=4.230,t=4.046,P均＜0.05).恶性组的微钙化构成比更高,且形态不规则、钙化位于结节内部、连续性中断、周围声晕及厚薄不均等钙化特征构成比均显著高于良性组(x2=10.211～31.090,P均＜0.05);TSH和FT4/FT3比值亦显著高于良性组(t=3.667、4.766,P均＜0.05).多因素Logistic分析显示,钙化分型、形态不规则等6项钙化特征及TSH和FT4/FT3等变量均为甲状腺结节恶性的独立危险因素(OR=4.766～8.566,95％CI=(1.028～1.700)～(22.101～49.749),P 均＜0.05).ROC 曲线分析表明,联合检测的诊断效能最高,其AUC为0.882,灵敏度为78.6％,特异度为88.2％.结论 甲状腺恶性结节超声钙化特征更典型,且TSH和FT4/FT3比值更高;二者联合检测对甲状腺结节良恶性具有较高诊断价值.
Objective To investigate the value of different ultrasound features of calcification combined with serum thyroid-stimulating hormone(TSH)and free thyroxine/free triiodothyronine(FT4/FT3)ratio in assessing the malignant nature of thyroid nodules.Methods A retrospective analysis was performed for 110 patients with thyroid nodules who were admitted to Cancer Hospital of Henan Province from June 2023 to May 2025,and according to the results of pathological examination,the patients were divided into benign group with 68 patients and malignant group with 42 patients.The two groups were compared in terms of general information,ultrasound features of calcification,and thyroid function parameters,and the receiver operating characteristic(ROC)curve and the area under the ROC curve(AUC)were used to assess diagnostic efficacy.Results The malignant group had a significantly higher proportion of female patients and a significantly greater mean nodule diameter(x2=4.230,t=4.046,both P＜0.05).The malignant group had the highest constituent ratio of microcalcification,and compared with the benign group,the malignant group had significantly higher constituent ratios of calcification features such as irregular morphology,intranodular calcification,interrupted calcification continuity,acoustic halo around calcification,and uneven thickness(x2=10.211-31.090,all P＜0.05),as well as significantly higher TSH level and FT4/FT3 ratio(t=3.667,4.766;both P＜0.05).The multivariate logistic regression analysis showed that the above six calcification features including calcification pattern and irregular morphology,TSH level,and FT4/FT3 ratio were independent risk factors for malignant thyroid nodule(OR=4.766-8.566,95％CI=1.028-1.700 to 22.101-49.749,all P＜0.05).The ROC curve analysis showed that combined measurement of the ultrasound features of calcifi-cation,TSH level,and FT4/FT3 ratio had the highest diagnostic efficacy,with an AUC of 0.882,a sensitivity of 78.6％,and a specificity of 88.2％.Conclusion Malignant nodules tend to have more typical ultrasound features of calcification,with higher TSH level and FT4/FT3 ratio,and combined measurement of these indicators has a relatively high value in the diagnosis of malig-nant thyroid nodules.
王婷婷;张倩;刘媛祎
郑州大学附属肿瘤医院(河南省肿瘤医院)超声科,河南郑州 450008郑州大学附属肿瘤医院(河南省肿瘤医院)超声科,河南郑州 450008郑州大学附属肿瘤医院(河南省肿瘤医院)超声科,河南郑州 450008
医药卫生
甲状腺结节钙质沉着症超声检查,多普勒,彩色促甲状腺素三碘甲状腺原氨酸甲状腺素
thyroid nodulecalcinosisultrasonography,Doppler,colorthyrotropintriiodothyroninethyroxine
《青岛大学学报（医学版）》 2026 (2)
329-333,5
河南省医学科技攻关计划联合共建项目(SBGJ-202402031)
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