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目的探讨术前辅助检查对甲状腺结节良恶性的预测价值。方法按标准纳入于2005年1月至2013年12月谢岗医院行手术治疗的甲状腺结节患者357例,术前均进行甲状腺B超、核素扫描及细针穿刺活检(FNA)检查,分析术前辅助检查对甲状腺结节良恶性的预测价值。结果甲状腺超声检查敏感度为12.0%,特异度为98.9%,诊断准确度为82.9%;核素扫描检查敏感度为23.0%,特异度为86.0%,诊断准确度为72.8%。多数患者仅进行原发病灶FNA,少数患者进行原发病灶或淋巴结FNA,两者的敏感度分别为52.9%、63.1%,特异度分别为88.6%、93.3%,诊断准确度分别为78.8%、93.3%。经多因素Logistic回归分析,实性结节、颈部淋巴结肿大、结节钙化、结节质硬是影响甲状腺结节良恶性的预测指标。结论甲状腺B超、核素扫描及FNA对恶性甲状腺病变均有一定的提示作用,尤其是FNA在判断结节性质方面具有较高的预测价值。
Objective To investigate the predictive value of preoperative auxiliary examination for benign and malignant thyroid nodules. Methods Thirty-five patients with thyroid nodules surgically treated in Xiegang Hospital from January 2005 to December 2013 were enrolled in this study. All patients underwent thyroid biopsy, radionuclide scanning and fine needle aspiration biopsy (FNA) before operation, Predictors of benign and malignant thyroid nodules in antegrade examination. Results The sensitivity, specificity and accuracy of thyroid ultrasound examination were 12.0%, 98.9% and 82.9% respectively. The sensitivity and specificity of nuclide scanning were 23.0%, 86.0% and 72.8% respectively. The majority of patients only had primary FNA, and a few patients had primary lesion or lymph node FNA. The sensitivity of the two was 52.9% and 63.1% respectively, the specificity was 88.6% and 93.3% respectively, and the diagnostic accuracy was 78.8% 93.3%. Logistic regression analysis showed that solid nodules, cervical lymph nodes, calcification of nodules and hard nodules were the predictors of benign and malignant thyroid nodules. Conclusions Thyroid B-scan, radionuclide scan and FNA have some implications for malignant thyroid lesions. In particular, FNA has high predictive value in judging the nodular properties.