| 摘要: |
| 目的：比较ACR TIRADS、ATA指南及KSThR指南在甲状腺囊实性结节危险分层中的应用。
方法：回顾分析本院293例甲状腺囊实性结节的超声影像学特征，比较良恶性结节超声影像学特征及不同TIRADS对甲状腺囊实性结节良恶性的预测价值。
结果：46.1%(135/293)的结节接受手术治疗，其中83个为甲状腺乳头状癌（Papillary thyroid cancer，PTC），52个结节为良性；53.9%(158/293)的结节经细胞病理证实为结节性甲状腺肿后未接受手术治疗。比较良恶性结节超声影像学特征，多因素分析结果显示实性部分低回声(OR值：6.684，95%CI：3.158-14.148，P＜0.001)、伴有微钙化(OR值：2.459，95%CI：1.839-3.287，P＜0.001)、边界不规则（OR值：2.587，95%CI：1.068-6.264，P=0.035）结节的恶性风险较高。通过分析ROC曲线下面积，ACR TIRADS分层系统曲线下面积最大，为0.843[95% CI: 0.791-0.895，p＜0.001]，ATA指南次之，为0.797[95% CI: 0.733-0.862，p＜0.001]。KSThR指南最低，为0.785[95% CI: 0.717-0.8524，p＜0.001]。
结论：甲状腺囊实性结节伴有实性部分低回声、微钙化、边界不规则时恶性风险较高。ACR TIRADS在甲状腺囊实性结节危险分层方面稍优于ATA及KSThR指南，建议用于临床实践中对甲状腺囊实性结节进行危险分层。 |
| 关键词: 甲状腺囊实性结节 甲状腺乳头状癌 TIRADS |
| DOI： |
| 投稿时间：2022-08-08修订日期：2022-09-03 |
| 基金项目:国家自然科学基金(No. 81970679),陕西省自然科学基础研究计划(No. 2019JQ-946) |
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| To compare the application of different TIRADS in the risk stratification of partially cystic thyroid nodulesShu Liu, Yanjun Liu, Zhuoqun Ma, Yanru, Zhao, Wei Wei* , Bingyin Shi |
| Liu shu,liu yanjun,ma zhuoqun,zhao yanru,wei wei,shi bingyin |
| (he First Affiliated Hospital of Xi’an Jiaotong University) |
| Abstract: |
| Objective: Compared ACR TI-RADS, ATA and KSThR ultrasound classifications performance in predicting high risk of partially cystic nodules
Methods: The sonography features from a total of 293 partially cystic thyroid nodules in our hospital were retrospectively analyzed to compare the difference between benign and malignant nodules, and also assess the predictive values of the three TIRADS in identifying high risk of partial cystic thyroid nodules.
Results: 46.1% (135/293) nodules underwent surgery, including 83 papillary thyroid cancer (PTC) and 52 benign nodules. 53.9% (158/293) nodular goiter diagnosed by cytology didn’t submit to operation. The sonographic characteristics were analyzed between benign and malignant nodules, the hypoechogenicity of solid portion (OR: 6.684，95%CI：3.158-14.148，P＜0.001), the presence of microcalcification (OR: 2.459，95%CI：1.839-3.287，P＜0.001) and irregular margin (OR: 2.587，95%CI：1.068-6.264，P=0.035) showed a statistically significant association with malignant nodules by Binary logistic regression analysis. ACR TI-RADS exhibited the highest area under the curve of ROC (0.843, 95% CI: 0.791-0.895，p＜0.001), and that of the ATA and KSThR were 0.797 (95% CI: 0.733-0.862，p＜0.001) and 0.785 (95% CI: 0.717-0.8524，p＜0.001), respectively.
Conclusion: The presence of the hypoechogenicity of solid portion, microcalcification and irregular margin showed high risk of malignancy in partially cystic thyroid nodules. The ACR TIRADS classification system showed slightly more effective in the risk stratification of partially cystic nodules than ATA and KSThR , and was suggested to apply in clinical practice to manage the partially cystic thyroid nodules. |
| Key words: partially cystic thyroid nodule papillary thyroid carcinoma TIRADS |
