甲状腺癌流行病学分析及超声诊断价值(1)
摘要：目的 分析甲狀腺癌的流行病学特点以及超声诊断价值，为该病的防治及诊断提供参考依据。方法 选取2015年7月～2018年2月安徽省立医院普外科1703例初次行甲状腺手术患者，其中987例术后病理证实为甲状腺癌，收集患者性别、年龄、职业、居住地、诊断结果及病理类型，并运用受试者操作特性(ROC)曲线评价甲状腺彩色多普勒超声TI-RADS分级法对甲状腺癌的诊断价值。结果 1703例初次行甲状腺手术患者，术前彩色多普勒超声结果提示548例为甲状腺良性结节，1155例为甲状腺恶性结节，术后病理结果提示716例为甲状腺良性病变，987例为甲状腺恶性肿瘤。987例术甲状腺癌患者中，男性261例(26.44%)，女性726例(73.56%)，男女发病年龄高峰均为41～50岁;长江以南地区68例(6.89%)，长江以北地区919例(93.11%);体力劳动者281例(28.47%)，脑力劳动者共392例(39.72%)，患者职业不详314例(31.81%);乳头状癌963例(97.57%)，滤泡状癌6例(0.61%)，髓样癌10例(1.01%)，未分化癌8例(0.81%)，女性甲状腺乳头状癌、滤泡状癌占比高于男性，而髓样癌、未分化癌占比低于男性，差异均有统计学意义(P<0.05);彩色多普勒超声TI-RADS分级法诊断甲状腺癌的灵敏度为94.22%，特异度为68.58%。经彩色多普勒超声TI-RADS分级法诊断甲状腺癌的ROC曲线下面积(AUC)为0.835。结论 41～50岁女性是甲状腺癌的高发人群，病理类型以甲状腺乳头状癌最为多见，甲状腺彩色多普勒超声TI-RADS分级法对甲状腺癌具有较高的诊断价值。
关键词：甲状腺癌;流行病学;病理类型;TI-RADS分级;诊断价值
中图分类号：R736.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2020.05.025
文章编号：1006-1959(2020)05-0085-03
Abstract：Objective To analyze the epidemiological characteristics and diagnostic value of thyroid cancer in order to provide a reference for the prevention and diagnosis of the disease. Methods 1703 patients who were initial thyroid surgery in General Surgery Department of Anhui Provincial Hospital were selected from July 2015 to February 2018， 987 of whom were confirmed as thyroid cancer by postoperative pathology. The patients' gender， age， occupation， residence， diagnosis results and pathological types were collected. The diagnostic value of TI-RADS grading method of color Doppler ultrasound for thyroid cancer was evaluated by ROC curve Value. Results In 1703 patients who were initial thyroid surgery ， the results of color Doppler ultrasound showed that 548 cases were benign thyroid nodules， 1155 cases were malignant thyroid nodules， 716 cases were benign thyroid lesions and 987 cases were malignant thyroid tumors.Among the 987 patients with pathologically confirmed thyroid cancer， 261 were male (26.44%) and 726 were female (73.56%). The peak age of men and women were 41 to 50 years old; 68 patients (6.89%) in the south of the Yangtze River. There were 919 cases (93.11%) in the north of the Yangtze River; 281 cases (28.47%) were manual laborers， 392 (39.72%) were mental laborers， 314 (31.81%) were patients with unknown occupations， and 963 (97.57%) were papillary cancers， 6 cases of follicular carcinoma (0.61%)， 10 cases of medullary carcinoma (1.01%)， 8 cases of undifferentiated carcinoma (0.81%)， the proportion of papillary thyroid carcinoma and follicular carcinoma of women was higher than that of men， and the proportion of medullary carcinoma and undifferentiated carcinoma was lower than that of men，the differences were statistically significant (P<0.05). The sensitivity of color Doppler ultrasound TI-RADS classification for diagnosis of thyroid cancer was 94.22%， and the specificity was 68.58%. The area under the ROC curve (AUC) of color Doppler ultrasound TI-RADS classification for thyroid cancer diagnosis was 0.835 (P<0.05).Conclusion 41 to 50 years old women are a high-risk group of thyroid cancer. The pathological type is the most common type of papillary thyroid carcinoma. The color Doppler thyroid ultrasound TI-RADS classification method has high diagnostic value for thyroid cancer., 百拇医药(李婷婷 李素梅 许琳琳)
关键词：甲状腺癌;流行病学;病理类型;TI-RADS分级;诊断价值
中图分类号：R736.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2020.05.025
文章编号：1006-1959(2020)05-0085-03
Abstract：Objective To analyze the epidemiological characteristics and diagnostic value of thyroid cancer in order to provide a reference for the prevention and diagnosis of the disease. Methods 1703 patients who were initial thyroid surgery in General Surgery Department of Anhui Provincial Hospital were selected from July 2015 to February 2018， 987 of whom were confirmed as thyroid cancer by postoperative pathology. The patients' gender， age， occupation， residence， diagnosis results and pathological types were collected. The diagnostic value of TI-RADS grading method of color Doppler ultrasound for thyroid cancer was evaluated by ROC curve Value. Results In 1703 patients who were initial thyroid surgery ， the results of color Doppler ultrasound showed that 548 cases were benign thyroid nodules， 1155 cases were malignant thyroid nodules， 716 cases were benign thyroid lesions and 987 cases were malignant thyroid tumors.Among the 987 patients with pathologically confirmed thyroid cancer， 261 were male (26.44%) and 726 were female (73.56%). The peak age of men and women were 41 to 50 years old; 68 patients (6.89%) in the south of the Yangtze River. There were 919 cases (93.11%) in the north of the Yangtze River; 281 cases (28.47%) were manual laborers， 392 (39.72%) were mental laborers， 314 (31.81%) were patients with unknown occupations， and 963 (97.57%) were papillary cancers， 6 cases of follicular carcinoma (0.61%)， 10 cases of medullary carcinoma (1.01%)， 8 cases of undifferentiated carcinoma (0.81%)， the proportion of papillary thyroid carcinoma and follicular carcinoma of women was higher than that of men， and the proportion of medullary carcinoma and undifferentiated carcinoma was lower than that of men，the differences were statistically significant (P<0.05). The sensitivity of color Doppler ultrasound TI-RADS classification for diagnosis of thyroid cancer was 94.22%， and the specificity was 68.58%. The area under the ROC curve (AUC) of color Doppler ultrasound TI-RADS classification for thyroid cancer diagnosis was 0.835 (P<0.05).Conclusion 41 to 50 years old women are a high-risk group of thyroid cancer. The pathological type is the most common type of papillary thyroid carcinoma. The color Doppler thyroid ultrasound TI-RADS classification method has high diagnostic value for thyroid cancer., 百拇医药(李婷婷 李素梅 许琳琳)