摘要
目的分析在甲状腺功能正常人群中血清促甲状腺激素(TSH)与甲状腺球蛋白(Tg)比值对甲状腺结节良恶性的鉴别价值。方法回顾性分析我院诊治的400例甲状腺结节者的临床资料,根据病理诊断结果分为良性结节组(n=211)和恶性结节组(n=189)。测定所有甲状腺结节者血清TSH和Tg水平,计算血清TSH/Tg比值。结果甲状腺恶性结节组血清TSH/Tg比值显著高于良性结节组(P<0.05);logistic回归分析提示血清TSH/Tg比值(OR=2.626,95%CI 2.014~3.185,P<0.001)是恶性甲状腺结节发生的独立危险因素;随着血清TSH/Tg比值的升高,恶性甲状腺结节发生率逐渐升高(21.05%vs 54.13%vs 66.42%,P<0.05),良性甲状腺结节发生率逐渐降低(78.95%vs 45.87%vs34.58%,P<0.05);ROC曲线分析提示血清TSH/Tg比值对区分甲状腺良恶性结节有较好的预测价值,当截断值取40.12 IU/g时,TSH/Tg比值诊断恶性甲状腺结节的灵敏度为78.20%,特异度为67.60%。结论血清TSH/Tg比值可作为鉴别甲状腺良恶性结节的一种有效的血清学标记物。
Objective To analyze the differential diagnose value of serum thyrotrophin(TSH) and thyroglobulin(Tg) ratio for benign and malignant thyroid nodules in subjects with normal thyroid function.Methods The clinical data of 400 participants with thyroid nodules in our hospital were retrospectively analyzed and they were divided into the benign nodules group(n=211) and malignant nodules group(n=189) according to the pathological diagnosis.Serum TSH and Tg levels were measured in all participants with thyroid nodules,and serum TSH/Tg ratio was calculated.Results The serum TSH/Tg ratio of the malignant thyroid nodules group was significantly higher than that of the benign nodules group(P<0.05).Logistic regression analysis showed that serum TSH/Tg ratio(OR=2.626,95%CI 2.014-3.185,P<0.001) was an independent risk factor for the occurrence of malignant thyroid nodules.With the increase of serum TSH/Tg ratio,the incidence of malignant thyroid nodules gradually increased(21.05% vs 54.13% vs 66.42%,P<0.05),while the incidence of benign thyroid nodules gradually decreased(78.95% vs 45.87% vs 34.58%,P<0.05).ROC curve analysis suggested that serum TSH/Tg ratio had a good predictive value for differentiating benign from malignant thyroid nodules.When the cut-off value was 40.12 IU/g,the sensitivity and specificity of serum TSH/Tg ratio in diagnosing malignant thyroid nodules were 78.20% and 67.60% respectively.Conclusion Serum TSH/Tg ratio can be used as an effective serological marker to differentiate benign from malignant thyroid nodules.
作者
刘鹏
石宝刚
贺志强
LIU Peng;SHI Bao-gang;HE Zhi-qiang(Central Hospital of Jiaozuo Coking Coal Group,Jiaozuo 454000,China)
出处
《中国地方病防治》
CAS
2020年第6期688-690,694,共4页
Chinese Journal of Control of Endemic Diseases
