【摘要】 目的探讨临床结合超声的综合评分系统在诊断甲状腺良恶性结节中的预测价值。方法选取6项临床参数及6项超声参数建立量化评分系统,对745例施行甲状腺手术的患者进行分析评估。结果恶性结节患者平均分值较良性结节患者显著升高[(7.84±2.85)分vs.(4.21±1.22)分,P=0.004]。通过计算得出每一分值的恶性率,ROC曲线分析得出判断结节良恶性的最佳界点为5分,当评分大于5分时,其灵敏度为81.97%,特异度为86.91%。根据评分将甲状腺结节进行风险分层,低危:0~3分,恶性率2.44%;中危:4~6分,恶性率15.12%;高危:7~9分,恶性率81.62%;极高危:≥10分,恶性率96.43%。结论临床结合超声的评分系统可以有效预测甲状腺恶性结节的风险。更多还原

【Abstract】 Objective To investigate the predictive value of the scoring system based on clinical and ultrasonic features in the diagnosis of benign and malignant thyroid nodules.Methods 6 clinical parameters and6 ultrasonic parameters were selected to establish the quantitative scoring system.745 thyroidectomy patients were evaluated according to this system.Results The mean scores of patients with malignant nodules were significantly higher than those of benign nodules[(7.84±2.85)score vs.(4.21±1.22)score,P=0.004].Malignancy rates were calculated for each score.The score 5 was the most favorable point of convergence by ROC analysis in differentiating benign and malignant nodules.When the score was>5,the sensitivity and specificity were 81.97% and 86.91%,respectively.The risk stratification of thyroid nodules was performed according to the scoring system,low risk:0-3 score,2.44% malignancy,intermediate risk:4-6 score,15.12%malignancy,high risk:7-9 score,81.62% malignancy and extra high risk:≥10 score,96.43% malignancy.Conclusion The clinical scoring system combined with ultrasound can effectively predict the risk of malignant thyroid nodules in clinical practices.更多还原