中国普外基础与临床杂志

中国普外基础与临床杂志

术前 TSH 水平与甲状腺结节恶性风险的相关性

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目的 探究术前 TSH 水平与甲状腺结节恶性风险的相关性。 方法 回顾性分析 959 例甲状腺结节患者的病例资料,通过 SPSS 17.0 软件进行统计学分析。 结果 959 例患者中,良性结节组 746 例,甲状腺乳头状癌(PTC)组 213 例。PTC 患者术前的血清 TSH 水平高于良性结节患者[(2.32±1.65)mU/L 比(1.76±1.20)mU/L,P<0.001],并随 TSH 水平上升,PTC 的患病风险增加。术前 TSH 水平与 PTC 肿瘤直径、病灶数量和淋巴结转移情况无相关性(P>0.05)。logistic 回归分析结果显示,术前 TSH 水平是 PTC 发生的独立影响因素 [OR=1.315,95% CI 为(1.171,1.477),P<0.001]。TSH 诊断 PTC 的最佳临界值为 1.575 mU/L,此时灵敏度为 62.0%,特异度为 53.4%,受试者工作特征(ROC)曲线下面积为 0.602(P<0.001)。 结论 术前 TSH 水平与甲状腺结节恶性风险有一定的相关性,随 TSH 水平的上升 PTC 的患病风险增加。

Objective To study the correlation between preoperative serum thyroid stimulating hormone (TSH) level and the malignant risk of thyroid nodules. Methods This study retrospectively analyzed the medical records of 959 patients with thyroid nodules. Ststistical analysis was conducted by SPSS 17.0 software. Results There were 959 patients with thyroid nodules, of which 746 cases were benign, and 213 cases were diagnosed as thyroid papillary carcinoma (PTC). The preoperative TSH level of PTC patients was higher than that with benign nodules [(2.32±1.65) mU/L vs. (1.76±1.20) mU/L, P<0.001]. Moreover, the higher preoperative TSH level was, the higher risk of diagnosed as PTC would be. There was no correlation between the preoperative TSH level and tumor diameter, number of lesions, and lymph nodes metastasis in PTC (P>0.05). Logistic regression analysis showed that, the preoperative TSH level was an independent risk factor for PTC [OR=1.315, 95% CI was (1.171, 1.477), P<0.001]. The best critical value of TSH in the PTC diagnosis was 1.575 mU/L. At this point, the sensitivity was 62.0%, the specificity was 53.4%, and the area under the receiver operating characteristic (ROC) curve was 0.602 (P<0.001). Conclusion There is a certain correlation between preoperative TSH level and malignant risk of thyroid nodules, and the risk increases with the raise of preoperative TSH level.

关键词: 甲状腺结节; 促甲状腺激素; 甲状腺乳头状癌

Key words: thyroid nodule; thyroid stimulating hormone; thyroid papillary carcinoma

引用本文: 宋春峰, 刘满想, 倪传斗, 杨明军, 邢鹏, 张巍. 术前 TSH 水平与甲状腺结节恶性风险的相关性. 中国普外基础与临床杂志, 2018, 25(9): 1060-1064. doi: 10.7507/1007-9424.201802004 复制

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