【摘要】 目的探讨术前常规实验室检查预测甲状腺结节良恶性的可行性及其临床价值。方法回顾性分析1 243例甲状腺结节患者的术前促甲状腺素(TSH)、抗甲状腺球蛋白抗体(TgAb)/抗甲状腺过氧化物酶抗体(TPO Ab)水平与结节的超声检查特征及病理诊断间的关系,并进行准确率和特异性分析。结果癌患者中TSH、TgAb/TPO Ab升高的比例显著高于良性病例(7.0%∶3.1%,42.6%∶30.1%)。伴有TSH、TgAb/TPO Ab水平升高的甲状腺结节病例中癌的比例分别为33.3%和25.6%,显著高于未升高组(16.9%∶16.6%);伴有TSH、TgAb/TPO Ab升高的癌病例中出现多灶癌的比例分别为69.2%和30.2%,显著高于未升高组(16.7%∶2.9%),肿瘤平均浸润程度亦显著高于未升高组。TSH、TgAb/TPO Ab升高对诊断的甲状腺结节为癌的特异性、准确率分别为96.9%、82.1%和70.0%、64.7%。结论术前TSH、TgAb/TPO Ab升高是甲状腺结节为癌的危险因素,且与甲状腺多灶癌及浸润程度相关。更多还原

【Abstract】 【Objective】To discuss the feasibility and value of predicting differential diagnosis of benign and malignant thyroid nodules by laboratory examination before operation.【Methods】The records of 1 243 patients who underwent thyroidectomy for nodular thyroid disease were analyzed retrospectively.The relationship between pathological diagnosis and the results of laboratory test of TSH,TgAb/TPOAb and the ultrasonographic parameters were examined.【Results】Ratios of elevating serum level of TSH and TgAb/TPOAb were higher in malignant groups than benign groups(7.0% vs 3.1%,42.6% vs 30.1%).Ratios of malignant nodules were higher in groups with elevating TSH and TgAb/TPOAb than non-elevating groups(33.3% vs 16.9%,25.6% vs 16.6%).Among the carcinoma patients,ratios of multifocal thyroid carcinoma were higher in TSH and TgAb/TPOAb elevating groups than non-elevating groups(69.2% vs 16.7%,30.2% vs 2.9%),so as the level of tumor invasion.The specificity and accuracy of malignant diagnosis by elevation of TSH and TgAb/TPOAb were 96.9%,82.1% and 70.0%,64.7%,respectively.【Conclusion】Elevations of serum TSH and TgAb/TPOAb before operation are danger indicators for malignant thyroid nodules,and they are related to multifocal thyroid carcinoma and the level of tumor invasion.更多还原